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THU0257 Brucella Spondylodiscitis: A Study of Nineteen Cases
  1. R. Tekaya,
  2. M. Haj Tayeb,
  3. N. El Amri,
  4. H. Sahli,
  5. O. Saidane,
  6. I. Mahmoud,
  7. L. Abdelmoula
  1. Rheumatology, Charles Nicole Hospital, Tunis, Tunisia

Abstract

Background Brucellosis incidence has declined in developped countries, nevertheless it remains endemic in certains regions. Spondylodiscitis is the most frequent localisation of brucellosis infections complications, ranging from 30% to 85% according to cases series.

Objectives The aim of our study is to report the clinical and bacteriological features of this disease as well as its therapeutic profile.

Methods Retrospective study witch included medical records of patients treated for brucellar spondylodiscitis during the fifteen past years (2000–2014).

Results Nineteen cases were collected (12 males/ 7 females). Mean age was 52 years [rang 36 to 75]. All patients had at least a risk factor: exposed occupation in 6 cases, and unpastorized milk consumption in 12 cases). The following symtoms were observed: inflammatory back pain (14 cases), inflammatory dorsal pain (4 cases), raduculalgia with neurological signs were (1 cases), weight loss (13 cases), fever (14 cases), night sweating (4 cases), C Reactive protein was increased in 2 cases. Lymphopenia was noted in 1 case. Wright serology was positive in all cases. Standard X-ray showed narrowing in disc space in 5 cases, endplate destuction in 9 cases and bone condensation in 3 cases. MRI performed in 14 cases, showed Low signal on T1 weighted images and high signal on T2 weighted images of the vertebral bodies and intervertebral disc. Moreover it revealed epidural extension (5 cases) abcess formation (2 cases) and psoas abcess (6 cases). All patients were treated by association of antibiotics (doxycicline and rifampicin) for 2 to 3 months. Evolution was farorable with resolution of pain, normalization of biological inflammation and slow radiologic reconstruction in 10 cases. For one patient treatment was prolongated to one year due to the persistance of an epiduritis in the follow-up MRI.

Conclusions Prognosis of brucellar spondylodiscitis seems good under appropriate treatment. Nevertheless primary prevention is still necessary especially in countries where brucellosis is endemic.

Disclosure of Interest None declared

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