Brucellar spondylitis: review of 22 cases
Abstract number: R2373
Alp-Cavus S., Karlibas Z., Kuruuzum Z., Yuce A.
Objectives: Osteoarticular disease is the most common complication of brucellosis, and spondylitis is the most prevalent and important clinical form of osteoarticular involvement in adults with infections due to Brucella species. This study was carried out to describe the demographic, clinical, laboratory findings and treatment modalities of patients with brucellar spondylitis.
Methods: The clinical and laboratory characteristics of 22 patients with brucellar spondylitis followed in our clinic between January 2005 and October 2009 were evaluated retrospectively. The diagnosis was established on the basis of standard tube agglutination titre of 1/160 of antibodies for brucellosis and/or positive blood sample cultures. The diagnosis of spondylitis was based on clinical symptoms confirmed by Magnetic Resonance Imaging.
Results: In the study period, 64 patients were diagnosed as brucellosis. Twenty-two patients had spondylitis (%50 male). The mean age was 58.64±14.42 (1781). All patients except one were over the age of 40. Nearly half of patients (45%) were over the age of 60. Acute, subacute and chronic forms of infection's rates were 36.4%, 59.1% and 4.5%, respectively. Severe back pain (100%), fever (63.6%), weight loss (63.6%) were the most common clinical symptoms. Lumbar vertebrae were the most frequently involved regions (54.5%). Thoracolumbar, thoracal and cervical involment were seen in the 4, 4, and 2 patients, respectively. Spinal epidural abscess was found seven cases (31.8%). One patient had a psoas abscess. Standart tube agglutination test was positive (1/160) in 68.2% of the patients. Total culture positivity was 45.5% (blood 8, abscess specimen 2). Three patients underwent surgical intervention for diagnostic purposes. Other three patients required surgical treatment for vertebral stabilization. Nineteen patients (86.4%) received a combination of gentamycine (3 mg/kg/day for the initial 14 days) plus doxycycline (100 mg bid), and rifampicine (600 mg/day). Two patients received doxycycline plus rifampicine, one patient received doxycycline plus streptomycin. Duration of therapy varied according to clinical response and the presence of epidural and psoas abscess. The shortest duration of treatment was three months.
Conclusion: Brucellosis should be included in the differential diagnosis of back pain especially in the countries such as Turkey where this infection is endemic.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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