Clinical Findings, Therapeutic Approach, and Outcome of Brucellar Vertebral Osteomyelitis

Abstract

Vertebral osteomyelitis is a serious complication of brucellosis. It generates a high rate of therapeutic failure and functional sequelae. In the absence of more-powerful controlled studies, the duration of treatment of brucellar vertebral osteomyelitis should be 3 months.

Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region

“…In Nigeria, a mortality rate of 5.4% was reported (70). Of course, mortality rates might be biased by the selection of patients with specific clinical manifestations; for example, the rate was 2.1% in a series of patients with vertebral osteomyelitis in Spain (71). Brucella endocarditis is the main cause of death attributable to this disease (72)(73)(74), but many other causes have been described, eg, endotoxic shock with disseminated intravascular coagulation (75), rupture of a mycotic aneurysm (76), aortitis with mesenteric thrombosis (41), myocarditis (77), dissemination with multifocal liver and lung nodules (78), thrombocytopenia (79), and neurobrucellosis (14,29,41).…”

Brucelosis en Chile: Descripción de una serie de 13 casos

“…En los casos de brucelosis con focalización las terapias se prolongaron por cuatro meses (siendo lo mínimo recomendado tres meses) 17 , con respuesta satisfactoria en 100% de los casos.…”

Brucella spondylodiscitis: Multifocal involvement in thoracic and lumbar areas; a rare case

“…[4][5][6] In the literature, multi-focal involvement in the spinal area was observed to occur in 3-14% of all cases. [4][5][6] To the best of our knowledge, 14 similar cases with non-contiguous multi-focal involvement were previously reported in the literature (Table 1). 5,[7][8][9][11][12][13][14][15][16] Differential diagnosis between multi-focal brucellar spondylodiscitis and both degenerative disc diseases and tuberculosis is a major diagnostic problem.…”

“…MRI is also efficient in detecting multi-focal involvement, as well as, in diagnosing or excluding potential complications. 6,8 In brucellar spondylodiscitis, the abnormal results of hematological and biochemical tests are mostly mild and non-specific. 8 The diagnosis of brucellosis is frequently made by serological methods and in most of the cases STA titre is 1 ≥1/160.10 Colmenero et al reported STA titres <1/160 in 32.3% of osteomyelitis cases caused by brucella.…”

“…Surgery may provide fast recovery from symptoms and prevent the worsening of clinical and neurological complications. 6,20,21 Consequently, here, we aimed to present our case with brucellar spondylodiscitis involving the thoracic and lumbar spine regions simultaneously. In endemic regions like our country, brucellosis should be absolutely kept in mind for the differential diagnosis of the elderly patients presenting with complaint of longstanding thoracic and back pain.…”