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FRI0555 Osteoarticular Manifestations of Brucellosis: About Four Cases
  1. R. Hajji,
  2. S. Zribi,
  3. N. Kammoun,
  4. M. Elleuch,
  5. F. Derbali
  1. Internal Medicine, Sidi Bouzid Regional Hospital, Sidi Bouzid, Tunisia

Abstract

Background The incidence of brucellosis has dramatically decreased in the developed countries. it still remains endemic in some areas such as the Southern Mediterranean region. The osteoarticular disease is the most common location of infectious complications of brucellosis, almost 30-85% of cases depending on the series.

Objectives The aim of our work is to study the epidemiological, clinical, bacteriological and therapeutic osteoarticular brucellosis profile.

Methods This is a retrospective study concerning four cases of osteoarticular brucellosis admitted in internal medicine department of Sidi Bouzid Regional Hospital over a period from 2011 to 2014.

Results There were two men and two women, with an average age of 50 years. All patients had at least one risk factor (profession exposure in three cases and consumption of raw milk in four cases). The suduroalgic fever was constantly present, associated with a poor general condition in one case. Osteoarticular involvement was dominated by axial involvement in four cases (a case of lumbar spondylitis, a case of dorsal spondylitis, one case of cervical spondylitis and one case of unilateral sacroiliitis). Neurological signs were noted in two cases. Biology revealed an inflammatory syndrome in three cases. Serodiagnosis of Wright was positive in all the patients. Plain radiographs showed disc space narrowing associated with erosions of the vertebral endplates in three cases and localized erosion of the anterosuperior edge of the vertebra in one case. In the case of sacroiliitis, there was a pseudo-enlargement and irregularity of the articular space. The use of computed tomography and magnetic resonance imaging have revealed epidural extension in two cases and a paravertebral collection in two cases. The outcome was favorable under the rifampicin and doxycycline in three cases, with an average treatment duration of five months. One patient required a combination of antibiotics during one year associated with a surgical treatment.

Conclusions Brucellosis remains a public health problem in countries with low socioeconomic level. The brucella serology should always be part of the etiological investigation of infectious osteoarthritis. However, primary prevention remains essential.

Disclosure of Interest None declared

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