THU0257 Brucella Spondylodiscitis: A Study of Nineteen Cases

Tekaya, R.; Tayeb, Mohammad; Amri, N. El; Sahli, H.; Saidane, O.; Mahmoud, I.; Abdelmoula, L.

doi:10.1136/annrheumdis-2015-eular.6083

Cited by 4 publications

(4 citation statements)

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“…It is stated that 6%-85% of brucellosis osteoarticular involvements are related to brucellar spondylodiscitis. Lumbar (60%-69%), thoracic (19%) and cervical segments (6%-12%) are reported to be more involved in the spinal area[39-41]. Spondylodiscitis can be seen as single-focal and/or contiguous or non-contiguous multi-focal involvements.…”

Section: Osteoarticular Manifestationsmentioning

confidence: 99%

Osteoarticular manifestations of human brucellosis: A review

Esmaeilnejad-Ganji

2019

WJO

102

109

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Brucellosis is a common global zoonotic disease, which is responsible for a range of clinical manifestations. Fever, sweating and musculoskeletal pains are observed in most patients. The most frequent complication of brucellosis is osteoarticular involvement, with 10% to 85% of patients affected. The sacroiliac (up to 80%) and spinal joints (up to 54%) are the most common affected sites. Spondylitis and spondylodiscitis are the most frequent complications of brucellar spinal involvement. Peripheral arthritis, osteomyelitis, discitis, bursitis and tenosynovitis are other osteoarticular manifestations, but with a lower prevalence. Spinal brucellosis has two forms: focal and diffuse. Epidural abscess is a rare complication of spinal brucellosis but can lead to permanent neurological deficits or even death if not treated promptly. Spondylodiscitis is the most severe form of osteoarticular involvement by brucellosis, and can have single- or multi-focal involvement. Early and appropriate diagnosis and treatment of the disease is important in order to have a successful management of the patients with osteoarticular brucellosis. Brucellosis should be considered as a differential diagnosis for sciatic and back pain, especially in endemic regions. Patients with septic arthritis living in endemic areas also need to be evaluated in terms of brucellosis. Physical examination, laboratory tests and imaging techniques are needed to diagnose the disease. Radiography, computed tomography, magnetic resonance imaging (MRI) and bone scintigraphy are imaging techniques for the diagnosis of osteoarticular brucellosis. MRI is helpful to differentiate between pyogenic spondylitis and brucellar spondylitis. Drug medications (antibiotics) and surgery are the only two options for the treatment and cure of osteoarticular brucellosis.

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Section: Osteoarticular Manifestationsmentioning

confidence: 99%

Osteoarticular manifestations of human brucellosis: A review

Esmaeilnejad-Ganji

2019

WJO

102

109

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“…The prognosis of Brucella spondylodiscitis appears to be good when the condition is managed adequately [ 41 ], but early detection of complicated cases is crucial to circumventing the occurrence of serious complications and sequelae [ 28 ]. Nonetheless, as previously discussed, the principal challenge to an efficient management is establishing the diagnosis of Brucella in the first place.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, as previously discussed, the principal challenge to an efficient management is establishing the diagnosis of Brucella in the first place. It is suggested that primary prevention remains vital in endemic regions [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Noncontiguous multifocal Brucella spondylodiscitis with paravertebral abscess: a case report

et al. 2022

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Background Human brucellosis is the most frequently contracted zoonotic infection worldwide. Although being an old disease that carries minimal risks of mortality, it remains a source of considerable sequelae and disability. However, noncontiguous multifocal spinal involvement is an exceptional presentation of brucellosis; additionally, an associated paravertebral abscess is extremely rare. Case presentation This paper focuses on a 67-year-old Lebanese woman with noncontiguous multifocal Brucella spondylodiscitis, involving the T12–L1 and L3–L4 segments, with paravertebral abscess formation. She presented with a 3-week history of acute severe lumbar back pain, radiating to the lower extremities and associated with impaired mobility and lower extremity weakness. The patient complained of night sweating but had no fever. No lymphadenopathy, hepatomegaly, or splenomegaly could be observed. She had painful percussion of the lumbar spine, painful passive mobilization, and paravertebral tenderness, yet her neurological examination was completely normal. BrucellaCapt test was positive at a titer of 1/5120 (reference range 1/180). The patient was treated with an inpatient regimen for 2 weeks, which was followed by an outpatient oral antibiotic regimen with doxycycline, rifampin, and ciprofloxacin to complete a total treatment duration of 3 months. Magnetic resonance imaging was performed at the end of the treatment and showed a complete resolution of the paravertebral abscess. Conclusion Noncontiguous multifocal Brucella spondylodiscitis with paravertebral abscess is an extremely rare presentation. It may be effectively managed by antibiotic therapy, without surgery or drainage, in the absence of neurological complications. Nonetheless, the principal challenge to an efficient management is establishing the diagnosis of Brucella in the first place. In endemic countries, a strong suspicion of spinal involvement of brucellosis should be elicited in front of back pain presentations—even in the absence of fever and other related symptoms.

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“…It is stated that 6%-85% of brucellosis osteoarticular involvements are related to brucellar spondylodiscitis. Lumbar (60%-69%), thoracic (19%) and cervical segments (6%-12%) are reported to be more involved in the spinal area [51][52][53]. Spondylodiscitis can be seen as single-focal and/or contiguous or non-contiguous multi-focal involvements.…”

Section: Introductionmentioning

confidence: 99%

Polymorphism Of Osteoarticular Manifestation Of Brucellosis Infection. A Review

Yu.

Masoodi²,

Kurmanova

et al. 2020

IAM

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Brucellosis is a common zoonosis which still remains as a major health problem in certain parts of the world. Kazakhstan remains among the most disadvantaged territories of brucellosis from Commonwealth of Independent States countries. The involvement of the musculoskeletal system is one of the most common systemic manifestations in brucellosis infection. The frequency of osteoarticular involvement of brucellosis varies between 10% and 85%. Osteoarticular involvement includes spondylitis, sacroiliitis, osteomyelitis, peripheral arthritis, bursitis, and tenosynovitis. Sacroiliitis is the most common osteoarticular finding in adults. A high degree of suspicion in the diagnosis of brucellar spondylitis is essential to reduce the delay for the treatment. Thus, it should be essentially included in the differential diagnosis of longstanding back pain particularly in regions where brucellosis is endemic. Screening serologic tests for brucella should be used more widely even in presence of low index of suspicion, especially in endemic areas. According to studies, when diagnosed with chronic brucellosis, the results of serological studies were unreliable: the result of the standard agglutination test (SAT)-Wright's reaction was negative in 32.7% of cases in patients with chronic brucellosis. Imaging studies, including radiography, computed tomography (CT), magnetic resonance (MR) imaging, and bone scintigraphy, have been used for diagnosis. Radiography is limited to evaluating the focal form of spinal brucellosis and advanced disease at the joints. For instance, MR imaging has a low specificity to predict the exact cause of an osteoarticular lesion, and in case of arthralgia or symptoms of osteomyelitis or spondylodiscitis, the index of suspicion should be high in regions where the disease is endemic.

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THU0257 Brucella Spondylodiscitis: A Study of Nineteen Cases

Cited by 4 publications

References 0 publications

Osteoarticular manifestations of human brucellosis: A review

Osteoarticular manifestations of human brucellosis: A review

Noncontiguous multifocal Brucella spondylodiscitis with paravertebral abscess: a case report

Polymorphism Of Osteoarticular Manifestation Of Brucellosis Infection. A Review

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