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Brucellosis of the spine. A report of 3 cases
Abstract:
Three cases of spinal osteomyelitis due to brucellosis are reported, all in women. Radiological confirmation was delayed for at least three months after the first clinical manifestation, while in one patient a bone scan was positive at an early stage. In two of the three cases the diagnosis was delayed because of insufficient awareness of the disease. Spinal osteomyelitis caused by Brucella is indistinguishable radiologically from that caused by other micro-organisms and needle aspiration or exploration is frequently performed to establish the correct diagnosis. Increased awareness of brucellosis and the carrying out of appropriate blood cultures and serological tests may make these procedures unnecessary.
Insights
Diagnosing spinal osteomyelitis caused by brucellosis (a bacterial infection) can be delayed due to low awareness. Early bone scans may show positive results, but blood tests are key for timely diagnosis.
Area of Science:
- Infectious Diseases
- Orthopedics
- Radiology
Background:
- Brucellosis is a zoonotic infection that can affect multiple organ systems, including the spine.
- Spinal osteomyelitis is a serious infection of the vertebral bones, often presenting with non-specific symptoms.
Observation:
- This report details three cases of spinal osteomyelitis caused by Brucella in female patients.
- Radiological confirmation of spinal osteomyelitis was delayed by at least three months in all reported cases.
- One patient exhibited an early positive bone scan, while diagnosis in two cases was hindered by insufficient awareness of brucellosis.
Findings:
- Radiological features of Brucella-induced spinal osteomyelitis are indistinguishable from those caused by other pathogens.
- Diagnosis often necessitates invasive procedures like needle aspiration or surgical exploration.
- Early recognition through blood cultures and serological tests can potentially avoid invasive diagnostic methods.
Implications:
- Increased clinician awareness of brucellosis is crucial for prompt diagnosis of spinal infections.
- Implementing appropriate blood cultures and serological testing can expedite diagnosis and treatment.
- Timely diagnosis and treatment of spinal brucellosis can prevent long-term complications and reduce the need for invasive procedures.