Clinical and bacteriological profile of osteoarticular brucellosis

Abstract

Brucellosis is an anthropozoonosis that remains endemic in Tunisia. Osteoarticular involvement is the most common complication. The aim of this work was to study the epidemiological and clinical aspects of osteoarticular brucellosis and the contribution of different diagnostic methods. This is a retrospective study of cases of osteoarticular brucellosis treated at the Mohamed Kassab Institute of Orthopedics from 2011 to 2018. We collected 30 cases (23 males and 7 females), with a mean age of 46.73 years. The consumption of unpasteurized dairy products was reported in 63.3%. Spinal pain was consistently present (80%) associated with fever (60%). CT and MRI were used respectively in 19 and 13 cases. The Rose Bengal test was positive in all cases (100%). Wright's serodiagnosis was positive for 96.9% of cases with titers ranging from 120 to 3840 IU/L. The blood cultures were positive for 2 cases/7, the cultures were positive for 3 cases/6. The genomic diagnosis was positive for the two studied cases. The evolution was favorable in 86.42% of cases under the combination rifampicin and doxycycline. We observed 2 relapses and 1 resistance. The confirmation of the diagnosis takes into account a set of epidemiological, clinical, radiological and bacteriological arguments. Brucellosis remains a diagnosis to be evoked in the face of a particularly spinal osteoarticular disease.