Three Cases of Brucellar Spondylitis with Noncontiguous Multifocal Involvement

Area of Science:

• Infectious Diseases
• Orthopedics
• Radiology

Background:

• Brucellosis is an endemic zoonotic disease.
• Brucellar spondylitis typically presents as a unifocal lesion.
• Noncontiguous multifocal brucellar spondylitis is a rare but significant manifestation.

Observation:

• This report details three patients over 51 years old diagnosed with noncontiguous multifocal brucellar spondylitis.
• Diagnosis was confirmed via magnetic resonance imaging (MRI) and positive brucellar agglutination tests.
• All patients achieved a cure through a combination of antibrucellosis chemotherapy and surgical intervention.

Findings:

• Noncontiguous multifocal brucellar spondylitis requires high clinical suspicion, particularly in elderly individuals.
• Screening with serologic tests for brucellosis and whole spine MRI is vital for accurate diagnosis.
• The Wright agglutination test and whole spine MRI are key diagnostic modalities.

Implications:

• Increased clinician awareness of this rare condition is essential.
• Prompt and accurate diagnosis using serologic tests and MRI can reduce misdiagnosis and missed cases.
• While chemotherapy is the primary treatment, surgery serves as a complementary therapy, offering a safe and effective approach for noncontiguous multifocal brucellar spondylitis.