Current therapeutic strategy in osteoarticular brucellosis

Area of Science:

• Infectious Diseases
• Rheumatology
• Public Health

Background:

• Brucellosis is a significant zoonotic disease with high morbidity, primarily caused by B. melitensis.
• Osteoarticular Brucellosis (OB) is a common manifestation, affecting 2-77% of human cases, with spondylitis and spondylodiscitis being frequent complications.

Purpose of the Study:

• To review physician awareness regarding osteoarticular involvement in brucellosis.
• To summarize the clinical presentation, diagnostic methods, and current treatment strategies for Osteoarticular Brucellosis.

Main Methods:

• Literature review focusing on clinical studies and case reports related to Osteoarticular Brucellosis.
• Analysis of diagnostic modalities including serological tests (SAT, ELISA, PCR) and radiological assessments (CT, MRI).

Main Results:

• Osteoarticular Brucellosis commonly presents with non-specific symptoms like fever and joint pain, frequently affecting the lumbar and thoracic spine.
• Diagnosis relies on clinical signs, positive serology (SAT titer ≥1:160), and cultures, with imaging crucial for spinal involvement.
• Treatment involves multi-drug antibiotic regimens (e.g., doxycycline, streptomycin) for at least three months to prevent relapses; surgery may be needed for abscesses.

Conclusions:

• Enhanced physician awareness of OB's clinical presentation and diagnostic challenges is crucial.
• Optimal management of OB requires timely diagnosis and prolonged antibiotic therapy, with potential surgical intervention for complications.