مرکز منطقه ای اطلاع رساني علوم و فناوري - Brucellar spondylodiscitis: clinical and therapeutic features

Abstract :

Introduction : Brucellosis is an anthropozoonosisstill endemic in Africa and the Mediterraneanbasin. The aim of our study was to determinethe clinical and therapeutic characteristics ofbrucellar spondylodiscitis.Materials and methods: We conducted aretrospective study of 17 cases of brucellarspondylodiscitis collected at the Department ofRheumatology of Sousse in Tunisia over a periodof 19 years [1998-2017].Results: 15 men and 2 women of an averageage of 50 years were included in our study. Theduration of the disease was 5 months. Low backpain was found in 12 patients, lumbosciatalgia inone patient, cruralgia in one patient, back pain in2 patients, and cerebral brachial neuralgia in onepatient. Eleven patients presented with fever. Aspinal syndrome was noted in 14 patients. Spinalcord compression was found in 4 cases withmotor deficit in 2 cases. X-rays showed disc pinching with erosions of the vertebral plateausin 16 cases. A CT made in 2 cases showed apinch with erosions of the vertebral plates in bothcases associated with a paravertebral abscessin one case. Spinal MRI was performed in 13patients. Brucellar spondylodiscitis involved onlyone stage in 11 cases and was multistage in 2cases. The serodiagnosis of brucellosis (Wrightserogglutination and Card test) was positivein all cases. All our patients were placed undercyclin and rifampicin for an average duration ofantibiotic therapy of 7 months. A laminectomywith para-vertebral abscess evacuation wasperformed in one case. The progression wasfavorable except for a patient with neurologicalsequelae.conclusion: Brucellar spondylodiscitis is stillcommon in the Maghreb. It has an insidiousevolution responsible for a delayed diagnosis andthe occurrence of neurological complications.