Pınar KORKMAZ, Zeki ATAİZİ, Figen ÇEVİK, Nevil AYKIN, Hakkı GÜLDÜREN, Yeşim ALPAY, Gülay ŞİMŞEK

Brucella spondylodiscitis: Multifocal involvement in thoracic and lumbar areas; a rare case

Brusellozis bir çok organ ve dokuları tutabilen bir zoonotik enfeksiyondur. İskelet sistemi bruselloziste en sık etkilenen bölge olup, sıklığı % 2 ile % 53 arasında değişmektedir. Multifokal spinal tutulum nadirdir. Bu yazıda torakal ve lomber bölgeyi aynı anda tutan brusella spondilodiskit olgusunun sunulması amaçlanmıştır. Brusellaya bağlı multifokal spinal infeksiyonun tanısı MRI ile konulabilir. Özellikle endemik bölgelerde brusellozis tanısında en az iki adet serolojik test yöntemi kullanılması gerekmektedir. Endemik bölgelerde uzun zaman devam eden sırt ve bel ağrısı şikayeti olan hastalarda ayırıcı tanıda mutlaka brusellozis düşünülmelidir

Anahtar Kelimeler:

Brusellozis, spinal infeksiyon, spondilodiskitis

Brucellosis is a zoonosis that can affect many organs or systems. Musculoskeletal system is the most commonly affected site in brucellosis and the frequency of musculoskeletal system involvement varies between 2% and 53%. Multifocal spinal involvement is rare. Here, it was aimed to present our case with brucellar spondylodiscitis involving the thoracic and lumbar regions simultaneously. MRI is a useful imaging method in the diagnosis of multifocal spinal infection caused by brucellosis. Especially in endemic regions, at least two serological tests should be used in the diagnosis of brucellosis. Brucellosis should be absolutely kept in mind for the differential diagnosis of the elderly patients with complaint of longstanding thoracic and back pain in the regions where brucellosis is endemic. J Microbiol Infect Dis 2015;5(3): 129-132Key words: Brucellosis, spinal infection, spondylodiscitis.

Keywords:

Brucellosis, spinal infection, spondylodiscitis,

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Young EJ. Brucella species. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases. Philadelphia,PA: Churchill Livingstone, 2000:2386–2393.

Arkun R, Mete BD. Musculoskelatal brucellosis. Semin usculoskelet

Radiol 2011;15:470-479.

Turgut M, Turgut AT, Koşar U. Spinal brucellosis: Turkish experience based on 452 cases published during the last century.

Acta Neurochir (Wien) 2006;148:1033-1044.

Chelli Bouaziz M, Ladeb MF, Chakroun M, Chaabane S. Spinal

brucellosis: a review. Skeletal Radiol 2008;37:785-790.

Raptopoulou A, Karantanas AH, Poumboulidis K, et al. Brucellar

spondilodiscitis: noncontiguous multifocal involvement of the cervical, thoracic and lumbar spine. Clin Imaging 2006;30:214-217.

Colmenero JD, Ruiz-Mesa JD, Plata A, et al. Clinical findings, therapeutic approach, and outcome of brucellar vertebral osteomyelitis.Clin Infect Dis 2008;46:426-433.

Pourbagher A, Pourbagher MA, Savas L, et al. Epidemiologic,

clinical, and imaging findings in brucellosis patients with osteoarticular involvement. AJR Am J Roentgenol. 2006;187:873-880.

Chelli Bouaziz M, Bougamra I, Kaffel D, et al. Non contiguous multifocal spondylitis: an exceptional presentation of spinal brucellosis. Tunis Med 2010;88:280-284.

Samra Y, Hertz M, Shaked Y, et al. Brucellosis of the spine.A report of 3 cases. J Bone Joint Surg Br 1982;64:429-431.

Turunç T, Demiroğlu YZ, Alişkan H, et al. Brucellosis incases of end-stage renal disease. Nephrol Dial Transplant 2008;23:2344-2399.

Baqer MM, Qurtom MA, Abdulhadi Ali Al-Ajmi J, et al. Multifocal

brucellosis spondylodiscitis. Clin Nucl Med 2002;27:842-843.

Shalchian S, de Wispelaere F. Brucella spondylodiscitis with

multiple-level involvement, an unusual clinical presentation. Eur J Neurol 2007;14:1-2.

Solera J, Lazano E, Martinez-Alfaro E, et al. Brucellar spondylitis:

review 0f 35 cases and literature survey. Clin Infect Dis 1999;29:1440-1449.

Mrabet D, Mizouni H, Khiari H, et al. Brucellar spondylodiscitis

affecting non-contiguous spine levels. BMJ Case Rep 2011:1-4.

Charalambides C, Papademetriou K, Sgouros S, Sakas D.

Brucellosis of the spine affecting multiple non-contiguous levels. Br J Neurosurg 2010;24:589-591.

Zormpala A, Skopelitis E, Thanos L, et al. An unusual case of brucellar spondylitis involving both the cervical and lumbar spine. J Clin Imaging 2000;24:273-275.

Yılmaz E, Parlak M, Akalın H, et al. Brucellar spondylitis review

of 25 cases. J Clin Rheumatol. 2004;10:300-307.

Bozgeyik Z, Ozdemir H, Demirdag K, et al. Clinical and MRI findings of brucellar spondylodiscitis. Eur J Radiol 2008;67:153-158.

Buzgan T, Karahocagil MK, Irmak H, et al. Clinical manifestations

and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. J Infect Dis 2010;14:469-478.

Alp E, Doganay M. Current therapeutic strategy in spinal brucellosis. Int J Infect Dis 2008;12:573–577.

Ekici MA, Ozbek Z, Gökoğlu A, Menkü A. Surgical management

of cervical spinal epidural abscess caused by Brucella melitensis: report of two cases and review of the literature. J Korean Neurosurg Soc 2012;51:383-387.