Skeletal brucellosis

Brucellosis is a bacterial infection causing severe public and socioeconomic problem, most prevalent in human beings in those areas in which infection of cattle, dogs, pigs, and goats is common. Out of a total number of 100 patients, there were 65 males (65%) and 35 females (35%). Forty patients lost to follow-up. Detection of specific antibodies was done by brucella agglutination test. In majority of the patients the titre was 1:320; the highest titre was 1:2560 and least titre was 1:40. All the patients were treated by combination therapy of doxycycline 100 to 200 mg/day, rifampicin 600 to 900 mg/day and streptomycin one g/day (for high titres above 600 IU) for six weeks. To check the efficacy of treatment the titres were repeated after four weeks, in 42 (70%) the titres were negative, 1:40 in 8 (13%), 1:80 in 4 (7%), 1:160 in 4 (7%) and 1:640 in 2 (3%). Brucella is a zoonotic disease and found most commonly in person who handles the animal most frequently but can occur in other persons also by other modes of infection. The most common joint involved was sacro-iliac joint in 31 (52%) and least common joints involved were ankle and elbow 2 (3%) each. The patients responded well to three-drug regimen and their antibody titre came down drastically following four weeks of treatment.