From the Guidelines
Brucellosis affecting the spinal site typically manifests as brucellar spondylitis or spondylodiscitis, characterized by back pain, and sometimes severe infections of the spine.
Clinical Manifestations
- The clinical manifestations of Brucellosis affecting the spinal site include:
- Back pain
- Fever
- Sweats
- Headache
- Physical weakness
- Spinal osteomyelitis
- Spondylodiscitis
- Neurobrucellosis (in rare cases) 1
Diagnosis and Treatment
- Diagnosis of brucellar spondylitis or spondylodiscitis often involves magnetic resonance imaging (MRI) of the spine 1
- Treatment of brucellar spondylitis varies widely, but the duration of treatment is a key factor in determining the outcome, rather than the specific regimen used 1
- Aminoglycoside-containing regimens may be superior to rifampicin-containing ones in the treatment of brucellar spondylodiscitis 1
- Immobilization of the spine, especially in cases of cervical involvement, is crucial to avoid devastating neurological complications 1
From the Research
Clinical Manifestations of Brucellosis Affecting the Spinal Site
The clinical manifestations of Brucellosis affecting the spinal site include:
- Spondylitis: inflammation of the spine [(2,3,4,5)]
- Spondylodiscitis: inflammation of the intervertebral disc and adjacent vertebrae [(2,3,4,5)]
- Discitis: inflammation of the intervertebral disc [(3,5)]
- Epidural abscess: a collection of pus in the epidural space surrounding the spinal cord [(3,5,6)]
- Paraspinal abscess: a collection of pus in the paraspinal muscles [(5,6)]
- Vertebral collapse: collapse of the vertebral body 5
- Spinal stenosis: narrowing of the spinal canal 6
- Back pain: pain in the back [(2,3,4,5)]
- Radiculopathy: pain or numbness in the arms or legs 5
- Paraparesis: weakness or paralysis of the legs 5
- Neurological deficits: weakness, numbness, or paralysis of the arms or legs [(4,5)]
Forms of Spinal Brucellosis
Spinal brucellosis can present in two forms:
Diagnosis and Treatment
Diagnosis of spinal brucellosis is made through a combination of:
- Physical examination [(3,4)]
- Laboratory tests: such as Rose-Bengal test and Brucella standard tube agglutination test 4
- Imaging techniques: such as radiography, computed tomography, magnetic resonance imaging (MRI), and bone scintigraphy [(3,4,6)] Treatment of spinal brucellosis typically involves:
- Antibiotic therapy: such as doxycycline and streptomycin [(2,4)]
- Surgery: may be necessary in cases of severe neurological deficit, incapacitating back pain, or epidural abscess [(5,6)]