Brucellosis of the spine

Area of Science:

• Infectious Diseases
• Orthopedics
• Microbiology

Background:

• Spinal brucellosis remains a significant cause of disability globally, particularly in regions outside North America and Europe.
• Diagnosis requires a high index of suspicion due to non-specific signs and symptoms.
• Risk factors include occupational exposure (farming) and consumption of unpasteurized dairy products.

Purpose of the Study:

• To retrospectively review cases of spinal brucellosis over a 20-year period.
• To evaluate diagnostic challenges and treatment outcomes.
• To highlight the role of radiological assessment and differential diagnoses.

Main Methods:

• Retrospective review of 15 consecutive spinal brucellosis cases.
• Analysis of patient history, clinical presentation, diagnostic methods (including cultures and radiology), and treatment regimens.
• Assessment of treatment efficacy and need for surgical intervention.

Main Results:

• Brucella bacilli culture confirmed diagnosis in seven patients.
• Conservative management (immobilization and antimicrobial therapy) was the primary treatment approach.
• Ofloxacin combined with rifampin or ofloxacin monotherapy demonstrated efficiency as initial treatment regimens.
• Surgery was required in three cases due to diagnostic difficulties.

Conclusions:

• Spinal brucellosis necessitates a high index of clinical suspicion for timely diagnosis.
• Effective conservative treatment options include antimicrobial therapy with ofloxacin and rifampin or ofloxacin monotherapy.
• Radiological assessment is crucial for diagnosis and in considering differential diagnoses.