title: Diagnostic clues for spondylitis in acute brucellosis.
abstract: OBJECTIVE
  To determine the diagnostic factors for brucellar spondylitis.
  
  
  METHODS
  This retrospective study included 227 consecutive brucellosis patients admitted to the Infectious Diseases and Clinical Microbiology clinics of Adiyaman State Hospital and Adiyaman 82 nd Year State Hospital, Adiyaman, Turkey between January 2010 and December 2012. Acute brucellosis was diagnosed by standard tube agglutination test and/or growth of Brucella spp. in appropriately prepared culture media (Bactec). Brucellar spondylitis was diagnosed and followed-up with contrast-enhanced magnetic resonance imaging.
  
  
  RESULTS
  Among the 227 brucellosis patients included, 88 (38.8%) were male, and 139 (61.2%) were female. Brucellar spondylitis was detected in 54 patients (23.7%). Brucellar spondylitis patients had higher mean age, higher fever, and higher blood culture positivity rate when compared with brucellosis patients (p=0.001, p=0.001, and p=0.001). Logistical regression analysis determined that male gender (OR: 3.006), older age (OR: 1.025), erythrocyte sedimentation rate (ESR) (OR: 1.067), high fever at the time of admission (OR: 2.550), and positive blood cultures for Brucella spp. (OR: 4.003) values were independently associated with brucellar spondylitis. However, high C-reactive protein (CRP) levels (OR: 0.971) were not found as a risk factor for brucellar spondylitis.
  
  
  CONCLUSIONS
  The results of this study shows that the risk of developing brucellar spondylitis is high in patients with acute brucellosis, who are at advanced age, who have high fever, that have Brucella spp. growth in their blood culture that has a high ESR value, and who are male.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Selcuk University, Selcuk, Turkey. E-mail. naktugdemir@yahoo.com.
authors.forename: Nazlim
authors.initials: N
authors.lastname: Aktug-Demir
authors.forename: Servet
authors.initials: S
authors.lastname: Kolgelier
authors.forename: Serap
authors.initials: S
authors.lastname: Ozcimen
authors.forename: Sua
authors.initials: S
authors.lastname: Sumer
authors.forename: Lutfi S
authors.initials: LS
authors.lastname: Demir
authors.forename: Ahmet C
authors.initials: AC
authors.lastname: Inkaya
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002006:Brucellosis / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013166:Spondylitis / Q000150:complications / Q000175:diagnosis*