Management of spinal brucellosis and outcome of rehabilitation

Abstract

Study Design: Review of cases. Objective: To review cases of brucellosis in order to clarify diagnostic guidelines, treatment regimes and prognosis. Setting: University Hospital, Turkey. Methods: Study of 11 patients (9 male, 2 female) with either brucellar spondylitis or epidural brucellar abscess. Diagnosis made on clinical presentation, laboratory findings, radiographic evidence and a minimum brucellar anti body of 1 : 160, a positive bacteriological culture and/or histological finding of inflammation of granulomatous tissue. All patients were treated with a combination of oral antibiotics. Surgery was performed in 8 patients. Results: At least 6 months antibiotic therapy using Rifampicin and Doxycycline is recommended. Surgery is indicated in the presence of spinal instability, cord compression or radiculopathy. In our series eight patients required surgery. Conclusion: The patients complaining of back pain, particularly in endemic areas should be investigated as possible cases of brucellosis.