Brucella spondylitis: an important treatable cause of low backache.
OBJECTIVE
This study was undertaken to see if brucella spondylitis existed as a cause of backache in Mumbai and to identify the clinical setting in patients of backache where brucella serology is indicated.


METHODS
In 18 months (June 1996-Dec. 1997) we performed tube agglutination test (TAT) for Brucella melitensis and abortus on 72 patients of low backache from Orthopaedics Department of a teritary health centre. All 72 patients satisfied the inclusion and exclusion criteria designed to exclude radiologically detectable congenital or degenerative cause of backache.


RESULTS
Six out of 72 patients were seropositive for brucellosis. All six patients had either history of animal contact or ingestion of raw milk or milk product (cheese or paneer). The lumbosacral backache was severe, radiating to the legs and straight leg raising test was significantly positive, they had marked tenderness on spinous process of lower lumbar vertebrae. Changes of brucella spondylitis were present on plain radiogram of lumbosacral spine in three patients. Four patients had abnormalities on bone scintigraphy.


CONCLUSIONS
Low backache of brucella spondylitis closely simulates pain of prolapsed intervertebral disc. Serologic testing for brucellosis is an important step in management of such patients, especially when history of animal contact or raw milk or milk product ingestion is present, as the disease can be eminantly treated with antibiotics.
Gokhle
Y A
YA
Seth GS Medical College, Mumbai.
Bichile
L S
LS
Gogate
A
A
Tillu
A V
AV
Zamre
D000293:Adolescent; D000328:Adult; D000372:Agglutination Tests; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002003:Brucella abortus / Q000302:isolation & purification*; D017347:Brucella melitensis / Q000302:isolation & purification*; D002006:Brucellosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy / Q000209:etiology*; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D012293:Rifampin / Q000627:therapeutic use; D013166:Spondylitis / Q000188:drug therapy / Q000209:etiology*
D000900:Anti-Bacterial Agents; D004318:Doxycycline; D012293:Rifampin