Spinal brucellosis in Hulunbuir, China, 2011-2016

Area of Science:

• Infectious Diseases
• Epidemiology
• Radiology

Background:

• Brucellosis is a zoonotic disease with potential for widespread organ involvement.
• Spinal brucellosis (BS), a severe complication, requires specific diagnostic and management strategies.
• Hulunbuir is a known endemic region for brucellosis in China.

Purpose of the Study:

• To characterize human brucellosis with spine involvement in an endemic Chinese region.
• To analyze demographic, clinical, laboratory features, and treatment outcomes of spinal brucellosis.
• To compare cases with and without spinal involvement.

Main Methods:

• Retrospective analysis of 842 human brucellosis patients from Hulunbuir People's Hospital (2011-2016).
• Comparison of 67 brucellar spondylodiscitis (BS) cases with non-BS brucellosis patients.
• Magnetic resonance imaging (MRI) utilized for all suspected spinal cases.

Main Results:

• Spinal brucellosis patients averaged 50.5 years; common symptoms included back pain (92.5%), fever (85.1%).
• Lumbar spine involvement was most frequent (81.2%); *Brucella melitensis* (biovars 3 and 1) was identified.
• Antimicrobial therapy for BS lasted ≥3 months, longer if abscesses were present.

Conclusions:

• Spinal brucellosis should be suspected in endemic areas with back pain and fever.
• MRI is highly sensitive for diagnosing BS and differentiating it from other spinal infections.
• Findings can inform prevention, surveillance, and management strategies for spinal brucellosis in China.