title: Osteoarticular complications of brucellosis: a study of 169 cases.
abstract: Of 452 patients with brucellosis, 169 (111 male and 58 female) had osteoarticular complications. Brucella melitensis was isolated from the blood in 7.7% of the cases. Fever, chills, arthralgia, backache, high levels of C-reactive protein, positive rheumatoid factor, and splenomegaly were more frequent in osteoarticular brucellosis than in nonosteoarticular disease. Arthritis occurred in the hip joint in 90 cases (53%), knees in 61 (36%), sacroiliacs in 33 (20%), ankles in 25 (15%), elbows in nine (5.3%), shoulders in eight (5%), wrists in six (3.5%), and sternoclavicular arthritis occurred in three cases (1.8%). Spondylitis occurred in 10 cases (6%), osteomyelitis in four (2.4%), and tendinitis or bursitis in two (1.2%). Treatment with tetracycline or trimethoprim-sulfamethoxazole (TMP-SMZ) alone (four to eight weeks) or in combination with streptomycin (two to four weeks) resulted in a relapse rate of 16.6%. No relapses occurred in seven patients treated with repeated four- to six-weeks courses of rifampin plus tetracycline or TMP-SMZ plus streptomycin.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000209:etiology*; D002006:Brucellosis / Q000150:complications* / Q000188:drug therapy; D002062:Bursitis / Q000188:drug therapy / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000209:etiology*; D012293:Rifampin / Q000627:therapeutic use; D013166:Spondylitis / Q000188:drug therapy / Q000209:etiology*; D013307:Streptomycin / Q000627:therapeutic use; D013420:Sulfamethoxazole / Q000627:therapeutic use; D052256:Tendinopathy / Q000188:drug therapy / Q000209:etiology; D013752:Tetracycline / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
chemical_list: D004338:Drug Combinations; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013752:Tetracycline; D013420:Sulfamethoxazole; D012293:Rifampin; D013307:Streptomycin