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Updated: May 30, 2026
Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
[Osteoarticular brucellosis: an analysis of the past decade]
T Santiago1, J Rovisco, J Silva
1Hospitais da Universidade de Coimbra, Portugal. tlousasantiago@hotmail.com
Insights
Osteoarticular brucellosis affects nearly half of diagnosed cases in Portugal, primarily presenting as pain and spondylodiscitis. Early diagnosis and treatment are crucial for managing this significant public health concern.
Area of Science:
- Infectious Diseases
- Rheumatology
- Public Health
Context:
- Brucellosis remains a significant public health issue in Portugal.
- Osteoarticular involvement is a common complication of brucellosis.
- Characterizing these cases is essential for effective management.
Purpose:
- To characterize osteoarticular brucellosis cases at the University Hospital of Coimbra (HUC) over a decade (2000-2009).
Summary:
- A retrospective study identified 44 cases of osteoarticular brucellosis among 90 diagnosed patients.
- Spondylodiscitis, particularly in the lumbosacral region, was the most frequent manifestation.
- Magnetic resonance imaging (MRI) was the preferred diagnostic tool, and antibiotic therapy was administered to all patients.
Impact:
- Brucellosis requires obligatory declaration and has considerable socio-economic and public health implications.
- Understanding epidemiological patterns facilitates early intervention and improved therapeutic outcomes.
- This study highlights the persistent challenge of brucellosis in Portugal and the importance of targeted interventions.
Objectives:
Characterize Osteoarticular Brucellosis in the University Hospital of Coimbra (HUC) in the past decade.
Material And Methods:
A retrospective study of the cases diagnosed between January/2000 and December/2009 in the HUC.
Results:
Ninety patients were admitted with the dia-gnosis of brucellosis in our hospital, of whom 44 (49%; 18 men; 26 women, mean 49.5 years) had osteoarticular complications. Twenty-five (45%) patients had a positive epidemiological context. The most frequent clinical manifestation was local pain (73%) followed by polyarthralgias and constitutional symptoms. The C-reactive protein was the inflammatory marker most often increased (82%). The Rose Bengala test was positive in 42 patients, and a Wright's sero-aglutination above than 1/160 was detected in 28 patients. An etiologic agent was isolated in 28 (64%) patients, with 70% of positive blood cultures. The imaging procedure of choice was magnetic resonance imaging (MRI) (46%). The osteo-articular manifestation most frequent was spondylodiscitis (57%) with a lumbosacral involvement in 40%. All patients completed antibiotic therapy. One patient underwent surgery to drain the abscess. Patients had an average length of admission of 28.3 days, with a good outcome in 60%, and a reasonable outcome in 20%, despite 20% of the patients lost follow-up.
Conclusions:
Brucellosis is a disease of obligatory declaration not eradicated in Portugal, with a great impact on socio-economic and public health. So, this epidemiological knowledge of brucellosis cases, allows an early intervention and therapy.
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