Brucellosis spondylitis is a complication of brucellosis. Arthritis of the spine generally occurs several weeks after initial infection with Brucella and may involve any part of the spine, though the lumbar region is the most commonly affected site.
In most severe cases, Brucella will infect both the vertebral body and the intervertebral disc, resulting in a spondylodiscitis.
Ankylosing spondylitis is a common chronic rheumatic disease in male young adults. Brucellosis is a worldwide zoonosis and remains endemic in several Mediterranean countries, which may have features similar to other diseases, leading to serious problems of differential diagnosis.
Knee, hip and ankle joints are among the most common peripheral regions affected by brucellosis and these patients present with arthritis[15,70]. Shoulders, wrists, elbows, interphalangeal and sternoclavicular joints may also be involved[28,69,71].
Brucellosis can also cause long-lasting or chronic symptoms such as recurrent fevers, joint pain, testicular swelling, heart infections, nervous system impairment, depression, and fatigue. Death from brucellosis is rare.
Inflammation of the inner lining of the heart chambers (endocarditis). This is one of the most serious complications of brucellosis. Untreated endocarditis can damage or destroy the heart valves and is the leading cause of brucellosis-related deaths.
The symptoms of neurobrucellosis may include symptoms like headache, fever, or muscle or joint pain, along with neurologic symptoms such as confusion, meningoencephalitis, myelitis, peripheral and cranial neuropathies, and psychiatric manifestations.
According to the World Health Organization(WHO), the treatment regimen for brucellosis consists of a combination of doxycycline (100 mg twice a day) and rifampicin (600 mg/day) (both drugs administered for six months) plus streptomycin(1 g/day IM, 21 days).
Osteoarticular involvement is one of the most frequent symptoms of brucellosis. A variety of disorders have been reported including sacroiliitis, spondylitis, peripheral arthritis, osteomyelitis, and bursitis.
The majority of the patients had a positive titre of Brucella melitensis and abortus. In 42% of the patients radiographs of the thoraco-lumbar spine showed bony changes. This study stresses the importance of brucellosis as a cause of backache.
Eye inflammation, called uveitis.
One of the most common complications of ankylosing spondylitis, uveitis can cause rapid-onset eye pain, sensitivity to light and blurred vision.
Ankylosing spondylitis is caused by Klebsiella.
Symptoms and Signs of Brucellosis
Or onset may be insidious, with mild prodromal malaise, muscle pain, headache, and pain in the back of the neck, followed by a rise in evening temperature.
The disease causes flu-like symptoms, including fever, weakness, malaise and weight loss. Person-to-person transmission is rare. Brucellosis is a bacterial disease caused by various Brucella species, which mainly infect cattle, swine, goats, sheep and dogs.
In brucellosis, osteoarticular involvement is the most common complication, whether in the form of peripheral arthritis, sacroiliitis or spondylitis.
It can present as arthralgia, enthesopathy, osteomyelitis, arthritis, bursitis, tendonitis, and tenosynovitis [12] in the most commonly affected peripheral joints, which are the knee, hip, sacroiliac, and ankle, respectively [12,13].
Neurobrucellosis is a focal complication of brucellosis affecting both central and peripheral nervous system presenting varieties of signs and symptoms. The most reported manifestations are meningitis and meningoencephalitis. It is a rare presentation of brucellosis.
There's no cure for ankylosing spondylitis (AS), but treatment is available to help relieve the symptoms. Treatment can also help delay or prevent the process of the spine joining up (fusing) and stiffening.
Brucellosis can be treated with antibiotics – but it can take a long time, and treatment can be difficult. Depending on the severity of the illness – and when treatment is begun – it can take anywhere from a few weeks to a few months to recover.
Doctors usually confirm a diagnosis of brucellosis by testing blood or bone marrow for the brucella bacteria or by testing blood for antibodies to the bacteria. To help detect complications of brucellosis, your doctor may order additional tests, including: X-rays. X-rays can reveal changes in your bones and joints.
Neurologic changes have been detected in 3–5% of patients with brucellosis [1, 2]. The most common clinical manifestations of neurobrucellosis are fever, headache, and muscle rigidity. In addition, mental and motor sensory disorders may also occur.
We report here an unusual complication of brucellosis in a microbiology technologist. A 41-year-old male presented with an 8-day history of right ankle pain which, over a 3-day period, extended up to his calf where swelling and tightness developed.
Brucellosis may be considered as a cause of clinical or subclinical peripheral neuropathy and should be evaluated especially in endemic areas.