Brucellar spondylitis: review of 35 cases and literature survey.
Thirty-five patients aged 14-74 years (average, 54 years) who had brucellar spondylitis were treated between January 1991 and December 1997. The time from onset of symptoms to diagnosis of spondylitis ranged from 1 week to 8 months (median, 9 weeks). Back or neck pain (100% of patients), fever (66%), and constitutional symptoms (57%) were the most common symptoms. Cultures of blood specimens from 26 patients (74%) were positive for Brucella melitensis. The duration of antimicrobial therapy (median, 120 days; range, 45-535 days) varied according to clinical response and the presence of epidural and paravertebral masses. One of the 35 patients underwent surgical treatment of a spinal epidural abscess. Therapy failed for 9 patients (26%; 95% confidence interval [CI], 12%-43%), and 5 (14%; 95% CI, 5%-30%) had a relapse. There were no deaths or severe sequelae in this study. Brucellar spondylitis causes considerable suffering and absenteeism from work, but long-term clinical responses are favorable.
Solera
J
J
Department of Internal Medicine, Hospital General de Albacete, 02006 Albacete, Spain. jsolera@chospab.es.
Lozano
E
E
Martínez-Alfaro
E
E
Espinosa
A
A
Castillejos
M L
ML
Abad
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000627:therapeutic use; D017347:Brucella melitensis / Q000187:drug effects / Q000302:isolation & purification*; D002006:Brucellosis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D013166:Spondylitis / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D013307:Streptomycin / Q000627:therapeutic use
D000617:Aminoglycosides; D005839:Gentamicins; D004318:Doxycycline; D013307:Streptomycin