Characteristics and Management of Brucellosis-Related Spondylodiscitis: A Prospective Study

Abstract

Introduction: Brucellosis-Related Spondylodiscitis (BSD) presents diagnostic and therapeutic challenges due to nonspecific clinical signs, delayed appearance of radiological findings, and the lack of precise therapeutic consensus. Objective: This study aimed to determine the epidemiological, clinical, biological, radiological, therapeutic, and outcome characteristics of BSD. Patients and methods: A prospective study was conducted, including all patients hospitalized in the infectious diseases department between 2011 and 2020 with a confirmed diagnosis of BSD. Diagnosis was established based on a combination of clinical, biological, and radiological evidence. Result: The study comprised 41 cases. The mean age of patients was 52.2±15.7 years, with a male predominance (71%). Consumption of contaminated dairy products (90.2%) was the primary mode of transmission. The average time to consultation was 101.5±68 days. Febrile spinal pain was reported in all cases. Wright serology was positive in all cases. Brucella melitensis was isolated in 5 blood cultures (12.8%). The lumbar spine was the most commonly affected site (65.8%). Reported complications included paravertebral abscesses (61%), psoas abscesses (29.3%), epiduritis (61%), and spinal cord compression (14.6%). The most commonly used antibiotic combination was doxycycline-rifampicin-trimethoprim-sulfamethoxazole (39%). The mean treatment duration was 7.3±3.1 months. Favorable outcomes were observed in 63.1% of cases.