1/6. sacroiliitis and brucellosis.A 21-year-old Peruvian man presented with sacroiliitis, fever, elevated liver enzymes, abdominal and right scrotal pain. brucellosis was diagnosed based on culture and serological data. Appropriate therapy led to full recovery. Our case presents a timely reminder that brucellosis should always be considered as part of the differential diagnosis of sacroiliitis.- - - - - - - - - - ranking = 1keywords = sacroiliitis (Clic here for more details about this article) |
2/6. sacroiliitis as a sole manifestation of brucella melitensis infection in a child.A case of a 12-year-old boy with sacroiliitis documented by positive Tc-99m MDP and Ga-67 scans is described. Isolation of brucella melitensis from the blood and bone marrow established the diagnosis. He responded promptly to docycycline therapy. Throughout the course of his disease this boy had neither fever nor other signs of brucellosis, and x-ray was normal.- - - - - - - - - - ranking = 0.5keywords = sacroiliitis (Clic here for more details about this article) |
3/6. Brucella sacroiliitis. A case report.brucellosis is an uncommon infectious disease in the united states though it remains endemic in many parts of the world. signs and symptoms of the disease are highly variable, with musculoskeletal complaints occurring frequently. The combination of an uncommon infection presenting with protean manifestations often results in missed or delayed diagnosis in the western world.- - - - - - - - - - ranking = 2keywords = sacroiliitis (Clic here for more details about this article) |
4/6. Articular involvement in human brucellosis: a retrospective analysis of 304 cases.brucellosis is a zoonosis which in humans is caused by one of four species of the Brucella genus: B. melitensis, B. abortus, B. suis and B. canis. B. abortus is the species prevalent in north america and europe and B. melitensis in most developing countries. Differences in disease manifestations may be accounted for either by differences in the species or by differences in the host. Articular involvement in brucellosis, although recognized since 1904, has been variably emphasized. Three hundred and four cases of human brucellosis caused by B. melitensis, the prevalent species in peru, were seen during a 12-yr period in one Lima hospital. fever, malaise and hepatomegaly were the most frequent findings. Diagnosis was greatly improved when cultures were done in the biphasic Ruiz-Castaneda medium, rather than in trypticase soy broth. Serologic diagnosis is still important, and it should include standard tube testing, detection of IgG blocking antibodies and fractionation with 2-ME in chronic cases. The disease may take one of three courses: acute, (< 8 wk), chronic (> 8 wk) or undulant (periods of remissions and exacerbations). Four syndromes were recognized in a total of 33.8% of patients with brucellosis. The most frequent pattern (in approximately 46.6% of patients with arthritis) was sacroiliitis, usually non-destructive and either uni- or bilateral. The second most frequent articular syndrome was peripheral arthritis (38.8%), manifested either as a single large lower extremity joint or as an asymmetric pauciarthritis. Rarely patients presented with a rheumatoid-like arthritis. Mixed arthritis (7.8%) was a combination of the first two. The above forms occurred in patients with an acute or undulant course. spondylitis was the least common form of arthritis (6.8%), and differed significantly from the other forms of arthritis in the duration of symptoms (chronic course), age of patients (older individuals) and the paucity of fever and malaise. It also tended to be destructive. The arthritis usually resolved with the combined regimen of tetracycline (2 g p.o. for 21 days) and streptomycin (1 g i.m. for 21 days) without sequelae. Illustrative cases of these syndromes are presented. The relatively benign nature of most of the patients with bruccellar arthritis lead us to postulate that they are for the most part reactive arthritides. Host factors are thought to be important in determining the response to the infection, but they are yet to be identified. Our own genetic studies have failed to identify an increased frequency of B27 or CREG antigens in the patients with sacroiliitis.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 1keywords = sacroiliitis (Clic here for more details about this article) |
5/6. Spinal brucellosis in a southern california resident.Dynamic changes in patient demography that are currently altering the regional epidemiology of brucellosis attest to the need for physicians to reacquaint themselves with a disease that has been largely forgotten in the united states. This is especially the case in california, which has a large immigrant population and where brucellosis clearly appears to have evolved from an occupational to a food-borne illness. In our recent clinical experiences with several cases of brucellosis, food-borne transmission of the organism is the presumptive cause of the disease, as no causes were associated with occupational risks for exposure to the organism. This suggests that given a clinical history consistent with brucellosis, physicians working with patient groups at risk for food-borne exposure must inquire about the ingestion of unpasteurized dairy products specifically and early during the patient visit. A history of travel to areas endemic for brucellosis may further aid diagnosis. Although a predominance of nonspecific clinical signs and symptoms (such as fevers or arthralgias) often makes the clinical diagnosis difficult, the frequency and characteristic patterns of localized disease should heighten clinicians' index of suspicion and lower the threshold for a serologic investigation. Prominent musculoskeletal complaints (especially back pain) accompanied by constitutional symptoms such as fever, malaise, and weight loss may be consistent with brucellosis and a history of unpasteurized dairy ingestion should be elicited. Radiographic evidence that localizes the source of back pain as caused by sacroiliitis or spondylitis is highly suggestive of brucellosis in appropriate patients. In such cases, serologic tests should be persuaded early if warranted by the clinical impression.- - - - - - - - - - ranking = 0.5keywords = sacroiliitis (Clic here for more details about this article) |
6/6. Acute brucella sacroiliitis: clinical features.Although back pain is very common, the differential diagnosis may sometimes be very difficult. Both inflammation and infections of spinal or sacroiliac joints are examples of such causes. We report three cases of brucella sacroiliitis resembling acute low back pain or lumbar disc herniation. All patients had had a recent infection and were referred complaining of acute back pain with a suspicion of lumbar disc herniation. The complaints of all patients reduced dramatically after proper medication. Radiographs of all patients and bone scans of two patients revealed sacroiliitis. One of the patients was positive for HLA-B27; in the other two patients HLA-B27 could not be determined.- - - - - - - - - - ranking = 3keywords = sacroiliitis (Clic here for more details about this article) |