Brucellar spondylodiscitis: about 15 cases

Introduction : brucellosis is an endemic infection in Tunisia caused by facultative intracellular bacteria of the genus Brucella, it presents with a wide clinical spectrum. Osteoarticular involvement including spondylodiscites represents the most common complication of brucellosis. Methods : retrospective study in the Department of Internal Medecine of the Military Hospital of Tunis, from January 2000 to January 2016 including patients having brucellar spondylidiscitis. Results : we have studied 15 cases of spondylodiscites (9 men and 6 women), they were 61 year-old on average (31-78). They were from country areas and the source if infection was almost attributable to the consumption of contaminated milk or cheese in all cases. The clinical profile was made of prolonged fever and backache (100%), associated to neurological signs (67%). The location of spondylodiscites was lumber (9 cases), dorsal (6 cases) and cervical (2 cases). Spondylodiscites associated with vertebral abscess in 3 cases and epiduritis in 4 cases. Serological investigation showed that Rose Bengala and Wright seroaglutination were positive in all cases. The organism was identified in 6 cases: brucellosis melitensis. All of patients had medical treatment (rifampicin and tetracycline) associated to corticosteroids (4 cases) and orthopedic immobilization (9 cases). A good clinical outcome was notified for all patients. Conclusion : brucellosis represents a major public health problem in the Mediterranean region. Eradication of the disease in humans needs a multidisciplinary approach involving both humans and animals.