Spondylodiscitis: a common complication of brucellosis

  • Selda Sayin Kutlu Pamukkale University Faculty of Medicine, Denizli, Turkey
  • Murat Kutlu Pamukkale University Faculty of Medicine, Denizli, Turkey
  • Turkan Tuzun Denizli Surgery Hospital, Denizli, Turkey
  • Kevser Ozdemir Pamukkale University Faculty of Medicine, Denizli, Turkey
Keywords: Brucellar spondylodiscitis, clinical, diagnosis, epidemiology

Abstract

Introduction: Brucellar spondylodiscitis is a frequent and serious complication of brucellosis. The aim of this study is to describe the brucellosis patients with spondylodiscitis and the predictive factors related to spondylodiscitis in brucellosis.

Methodology: Laboratory-confirmed brucellosis patients from a low- to medium-endemic region were enrolled in the study and distributed into two groups. Group I consisted of patients with spondylodiscitis and Group II patients had no complications. Both groups were compared for predictive factors of spondylodiscitis.

Results: A total of 219 patients with active brucellosis were included in the study. We determined at least one complication in 91 (41.6%) patients. The most frequent complication was spondylodiscitis [n = 59 patients (26.9 %)]. In univariate analysis, age, time from symptom onset to diagnosis, presence of low back pain, increased levels of erythrocyte sedimentation rate, and alkaline phosphatases were the most significant predictive factors for spondylodiscitis among brucellosis cases. Presence of headache and thrombocytopenia were less frequent in patients with spondylodiscitis when compared to patients without complications (p = 0.024, p = 0.006 respectively). In multivariate analysis, old age (odds ratio [OR] 1,063; 95% confidence interval [CI] 1.026-1.101; p < 0.001), prolonged time between symptoms onset before diagnosis (OR 1.008; 95% CI 1.001-1.016; p = 0.031), and presence of low back pain (OR 12.886; 95% CI 3.978-41.739; p < 0.001) were indepedently associated with an increased risk of spondylodiscitis.

Conclusions: Spondylodiscitis is the most frequent complication of systemic brucellosis. Patients with low back pain, older age, and longer duration of symptoms should be considered as candidates of potential spondylodiscitis in brucellosis.

Author Biographies

Selda Sayin Kutlu, Pamukkale University Faculty of Medicine, Denizli, Turkey

Department of Infectious Diseases and Clinical Microbiology

Murat Kutlu, Pamukkale University Faculty of Medicine, Denizli, Turkey

Department of Infectious Diseases and Clinical Microbiology

Turkan Tuzun, Denizli Surgery Hospital, Denizli, Turkey

Department of Infectious Diseases and Clinical Microbiology

Kevser Ozdemir, Pamukkale University Faculty of Medicine, Denizli, Turkey

Department of Infectious Diseases and Clinical Microbiology

Published
2018-07-31
How to Cite
1.
Sayin Kutlu S, Kutlu M, Tuzun T, Ozdemir K (2018) Spondylodiscitis: a common complication of brucellosis. J Infect Dev Ctries 12:550-556. doi: 10.3855/jidc.10557
Section
Original Articles