From the Guidelines

Brucellosis infection affecting the spine typically manifests as spondylitis, often affecting the lumbar spine and leading to long-term damage.

The clinical presentation of Brucellosis can vary from an acute febrile illness to a chronic low-grade relapsing fever 1.
Osteoarticular disease is a common complication, with septic arthritis affecting large joints and sacroiliitis being most often seen 1.
Spondylitis is a recognized complication, which can lead to long-term damage, particularly when affecting the lumbar spine 1.
These complications, including spondylitis, predominantly occur during the acute infection phase 1.
Other complications, such as epididymo-orchitis, septic encephalitis, brain abscesses, and endocarditis, can also occur, but are not directly related to spinal infection 1.

From the Research

The clinical manifestations of Brucella infection affecting the spine are varied and can be nonspecific, making diagnosis challenging 2, 3, 4, 5, 6.

The most common location of infection of brucellosis is the musculoskeletal system, with the spine being involved in 2-54% of brucellosis infections 5.
The lumbar spine is most commonly affected, while cervical spine involvement is relatively rare 3.
Spinal epidural abscess is an infrequent complication that may occur during spondylitis caused by Brucella species 3.
Brucellar spondylodiscitis is a rare diagnosis that should be considered in patients with back pain and fever, especially those with a history of exposure to unpasteurized dairy products or employment in the meat industry 5.
Clinical features of spinal brucellosis may include excessive back pain, impeded walk, and fever, with magnetic resonance imaging confirming the diagnosis of spondylodiscitis in some cases 6.

Diagnosis of Brucella spondylitis is challenging and should be suspected in the appropriate epidemiological and clinical context, in correlation with microbiological and radiological findings 4.
Treatment depends largely on the affected parts of the body and may include antibiotic administration for an adequate period of time and, when appropriate, surgical intervention 4.
Early diagnosis and a multidisciplinary approach are crucial for effective management of spinal brucellosis 3.

Brucellosis is a worldwide zoonosis, with a significant economic and public health problem, particularly in the Mediterranean countries 2.
The disease can affect adults of any age, with an average age at diagnosis ranging from 47.53 to 51.12 years 3.
There are no significant demographic differences between male and female patients with spinal brucellosis, and no differences in occupational status or residence place 3.