Brucellar spondylitis: Review of 35 cases and literature survey

Thirty-five patients aged 14-74 years (average, 54 years) who had brucellar spondylitis were treated between January 1991 and December 1997. The time from onset of symptoms to diagnosis of spondylitis ranged from 1 week to 8 months (median, 9 weeks). Back or neck pain (100% of patients), fever (66%) , and constitutional symptoms (57%) were the most common symptoms. Cultures of blood specimens from 26 patients (74%) were positive for Brucella melit ensis. The duration of antimicrobial therapy (median, 120 days; range, 45-5 35 days) varied according to clinical response and the presence of epidural and paravertebral masses. One of the 35 patients underwent surgical treatm ent of a spinal epidural abscess. Therapy failed for 9 patients (26%; 95% c onfidence interval [CI]I, 12%-43%), and 5 (14%; 95% CI, 5%-30%) had a relap se. There were no deaths or severe sequelae in this study. Brucellar spondy litis causes considerable suffering and absenteeism from work, but long-ter m clinical responses are favorable.