Osteoarticular involvement in brucellosis: study of 196 cases in the Republic of Macedonia.
OBJECTIVE
To describe the frequency, types, clinical characteristics, diagnostic tools, and outcome of osteoarticular brucellosis.


METHODS
The study was carried out at the Hospital for Infectious Diseases in Skopje between January 1998 and December 2002. Three hundred and thirty one consecutive patients with brucellosis were enrolled and prospectively assessed according to a previously designed protocol. Brucellosis was diagnosed on the basis of clinical signs, and confirmed by the detection of specific antibodies at significant titers.


RESULTS
One hundred and ninety six (59.2%) patients had osteoarticular involvement. Peripheral arthritis was found in 119 (60.7%) patients, followed by sacroiliitis in 60 (30.6%) and spondylitis in 56 (28.6%) of them. In 86 (43.9%) patients, osteoarticular changes were localized in two or more sites. The patients with osteoarticular brucellosis showed more prolonged illness prior to diagnosis and higher erythrocyte sedimentation rate, compared to those without osteoarticular localization. There were no other significant demographic, epidemiological, clinical, and laboratory differences between the two groups. Relapses occurred in 28 (17.5%) and therapeutic failure in 25 (12.8%) patients, 24 of them with spondylitis.


CONCLUSIONS
Osteoarticular brucellosis was a common form of focal brucellosis and the most unfavorable outcome was seen in patients with spondylitis.
Bosilkovski
Mile
M
Bozidar Adzija Street 18/1-6, 1000 Skopje, Republic of Macedonia. mbosilkovski@yahoo.com
Krteva
Ljiljana
L
Caparoska
Sonja
S
Dimzova
Marija
M
D001170:Arthritis, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D001850:Bone Diseases, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002006:Brucellosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D011446:Prospective Studies; D012008:Recurrence; D018843:Republic of North Macedonia / Q000453:epidemiology; D012446:Sacroiliac Joint; D013166:Spondylitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D018709:Statistics, Nonparametric