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AB0931 Brucellar Spondylodiscitis – a Case Series Analysis
  1. D. Kaffel,
  2. A. Aouadi,
  3. I. Cherif,
  4. W. Hamdi,
  5. I. Zouch,
  6. M.M. Kchir
  1. Rheumatology, Kassab Institute, Manouba, Tunisia

Abstract

Background Brucellar spondylitis is rare. It is also the most prevalent clinical form of osteoarticular involvement in adults infected by Brucella.

Objectives The aim of this study was to report the clinical, biological, radiological and therapeutic features of brucellar spondylodiscitis.

Methods Retrospective study including 6 patients followed up in our department between 2006 and 2014.

Results We studied 6 cases (5 of them are male) with a mean age of 55.3 years old [20 - 83]. 3 patients were consumers of unpasteurized milk. The median delay of consultation was 6 months. All patients had fever, night sweats and generalized weakness. Lumbar spine was affected in 4 cases and cervical spine in 2 cases. Neurologic examination was normal in 5 cases, 1 patient had neurologic deficiency. Plain radiographs revealed narrowing of disc spaces in 5 cases and erosion of the antero-upper corner of the body of vertebra in 1 case. MRI was performed in all cases and revealed features suggesting spondylodiscitis in all patients. Epidural inflammation was found in 4 cases. Disco vertebral biopsy was performed in 1 patient revealing a nonspecific histological appearance and an inconclusive bacteriological study. Laboratory tests including CRP, sedimentation rate and leucocytes were increased in all cases. Rose-Bengale test and Wright test were positive in all of them. They were treated with double antibiotics (Rifadine and Cycline), during an average of 4 months in all cases. All of them had in immobilisation and also had a favourable development.

Conclusions Brucellar spondylodiscitis may be difficult to diagnose and have an acute or chronic course. Only rapid and correct management may prevent irreversible neurologic deficits and spinal deformities.

Disclosure of Interest None declared

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