Clinical and Para-clinical Features of Brucellosis With and Without Spondylodiscitis

Brucellosis is a common zoonotic disease with protean clinical manifestations. Osteoarticular involvement is the most common complication of the disease. This study aimed to compare the clinical and para-clinical manifestations of brucellosis among the patients with and without spondylodiscitis.

In this comparative and cross-sectional study, 135 patients having brucellosis with and without spondylodiscitis and admitted to Sina hospital in Hamadan, Iran from March 2009 to March 2014 were included. Clinical and para-clinical data of the patients were obtained from their medical records in the hospital based on a designed checklist.

Thirty-five patients having brucellar spondylodiscitis (BS) with the mean age of 55.60 ± 14.31 years, and 100 patients having brucellosis without BS with the mean age of 43.27 ± 18.35 years were examined. A significant difference was found between the mean age of the patients with spondylodiscitis and that of those without spondylodiscitis (P < 0.001). All patients with spondylodiscitis complained of back pain and vertebral tenderness, while 60% of the patients without BS suffered from back pain but experienced no vertebral tenderness (P = 0.003). The most common vertebral involvement in spinal MRI of the patients with BS was L4-L5 (45.7%). Patients with spondylodiscitis had more increased ESR and CRP than those without spondylodiscitis (P < 0.001).

It is recommended that Brucellar spondylodiscitis be considered in the differential diagnosis of the patients with prolonged fever, back pain, and vertebrae tenderness in the endemic areas.