BRUCELLOSIS OF THE SPINE

THE SPINAL FORM of brucellosis is still a disabling disease in many co untries outside North America and northern and central Europe. Fifteen consecutive cases of spinal brucellosis diagnosed and treated over a 20-year period were reviewed retrospectively. Six patients were farmer s, while 10 patients had a history of ingestion of unpasteurized milk or other dairy products. A high index of suspicion is necessary for th e diagnosis, since there are no pathognomonic signs or symptoms. Radio logical assessment of the disease was reviewed and highlights in the d ifferential diagnoses were stressed. The diagnosis was based on actual culture of Brucella bacilli in seven patients. The principal treatmen t of brucellosis of the spine is conservative, namely, immobilization and antimicrobial therapy. We have found both a combination of ofloxac in and rifampin and ofloxacin monotherapy efficient as the early regim ens used in this series. Three patients had to undergo surgery, since a diagnosis could not be made in any other way.