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Imaging of Vertebral Brucellosis

  • Ahmet Tuncay TurgutEmail author
  • Recep Brohi
  • Pelin Demir
  • Andrea Elefante
Chapter

Abstract

Brucellosis is a zoonotic disease, with sheep, goat, camel, livestock animals, etc., as the primary hosts and human beings as the secondary host. It is a member of the specie brucella with melitensis, abortus, suis, and canis subgroups being a Gram-negative short rodlike bacteria which are intracellular. This infection is endemic in some parts of the world, in particular in the Mediterranean basin. Involvement of the nervous system by the organism is seen in about 5–10 % of cases which may involve the central nervous system or may involve the spinal system, the latter being the subject of this chapter. The diagnosis is done by clinical and laboratory findings such as blood agglutinin levels, isolation of the species from blood flow, or other specimens. Along with the laboratory findings, plain X-rays, CT, MRI, and radionuclide studies are of importance. The treatment options are antibiotics as the first step in case of lack of neurologic deterioration. If neurologic deterioration occurs, surgical procedures can be carried by an anterior, posterior, or combined approach. Brucellosis is an infection which causes socioeconomic problems, so its diagnoses and treatment should be done carefully. Recent investigations and developments in medications and invasive techniques provide the chance to treat it thoroughly.

Keywords

Spine Brucella Neurobrucellosis Neuroimaging 

Abbreviations

CT

Computed tomography

MRI

Magnetic resonance imaging

PET

Positron emission tomography

References

  1. 1.
    Rubin B, Band JD, Wong P, Colville J (1991) Person-to-person transmission of Brucella melitensis. Lancet 1:14–15CrossRefGoogle Scholar
  2. 2.
    Hines PD, Overturf GD, Hatch D, Kim J (1986) Brucellosis in a California family. Pediatr Infect Dis 5:579–582CrossRefPubMedGoogle Scholar
  3. 3.
    Godfroid J, Cloeckaert A, Liautard JP, Kohler S, Fretin D, Walravens K, Garin-Bastuji B, Letesson JJ (2005) From the discovery of the Malta fever’s agent to the discovery of a marine mammal reservoir, brucellosis has continuously been a re-emerging zoonosis. Vet Res 36:313–326CrossRefPubMedGoogle Scholar
  4. 4.
    Bosilkovski M, Krteva L, Caparoska S, Dimzova M (2004) Osteoarticular involvement in brucellosis: study of 196 cases in the Republic of Macedonia. CMJ 45:727–733PubMedGoogle Scholar
  5. 5.
    Turgut M, Turgut AT, Koşar U (2006) Spinal brucellosis: the Turkish experience based on 452 cases published during the last century. Acta Neurochir (Wien) 148:1033–1044CrossRefGoogle Scholar
  6. 6.
    Young EJ (2000) Brucella species. In: Mandell GL, Bennet JE, Dolin R (eds) Principles and practice of infectious diseases, 5th edn. Churchill Livingstone, New York, pp 2386–2393Google Scholar
  7. 7.
    Tekkök IH, Berker M, Özcan OE, Özgen T, Akalın E (1993) Brucellosis of the spine. Neurosurgery 33:838–844PubMedGoogle Scholar
  8. 8.
    Özaksoy D, Yücesoy K, Yücesoy M, Kovanlıkaya I, Yüce A, Naderi S (2001) Brucellar spondylitis: MRI findings. Eur Spine J 10:529–533CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Gur A, Geyik MF, Dikici B, Nas K, Çevik R, Sarac AJ, Hosoglu S (2003) Complications of brucellosis in different age groups in Southeastern Anatolia of Turkey: a study of 283 cases. Yonsei Med J 44:33–44CrossRefPubMedGoogle Scholar
  10. 10.
    Ariza J, Gudiol F, Valvarde R, Pallares R, Fernandez-Viladrich P, Rufi G, Espalder L, Fernandez-Nogues F (1985) Brucella spondylitis: a detailed analysis based on current findings. Rev Infect Dis 7:656–664CrossRefPubMedGoogle Scholar
  11. 11.
    Bodur H, Erbay A, Çolpan A, Akıncı E (2004) Brucellar spondylitis. Rheumatol Int 24:221–226CrossRefPubMedGoogle Scholar
  12. 12.
    Yang XM, Wang YY, Shi W, Zhang Y, Zhang P, Ren YX (2014) Imaging classification and clinical significance of brucellosis spondylitis. J Spine 3:172Google Scholar
  13. 13.
    Turgut M, Şendur ÖF, Gürel M (2003) Brucellar spondylitis in the lumbar region. Neurol Med Chir (Tokyo) 43:210–212CrossRefGoogle Scholar
  14. 14.
    Gotuzzo W, Seas C, Guera JG, Carillo C, Bocanegra TS, Calvo A, Castaneda O, Alarcon GS (1987) Brucella arthritis: a study of 39 peruvian families. Ann Rheum Dis 46:506–509CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Yıldırım RC, Afşar OZ, Eker L (1997) Brucellosis in the World and Turkey (in Turkish). Sürekli Tıp Eğitimi Dergisi 6:189–192Google Scholar
  16. 16.
    Pourbagher A, Pourbagher MA, Savaş L, Turunç T, Demiroğlu YZ, Erol İ, Yalçıntaş D (2006) Epidemiologic, clinical, and imaging findings in brucellosis in patients with osteoarticular involvement. AJR Am J Roentgenol 187:873–880CrossRefPubMedGoogle Scholar
  17. 17.
    Özgeçmen S, Ardıçoğlu Ö (1999) Osteoarticular brucellosis. J Rheumatol 3:322–325Google Scholar
  18. 18.
    Naderi S, Yücesoy K, Mertol T, Arda MN (2000) Epidural brucella abscess. Report of a spinal brucellosis manifesting itself with epidural abscess. Neuro-orthopedics 28:11–15Google Scholar
  19. 19.
    Demirci I (2003) Brucella discitis mimicking herniation without spondylitis: MRI findings. Zentralbl Neurochir 64:178–181CrossRefPubMedGoogle Scholar
  20. 20.
    Sharif HS, Aediyan OA, Clark DC, Madkour MM, Aebed MY, Mattsson TA, al-Deeb SM, Moutaer KR (1989) Brucella and tuberculous spondylitis: comparative imaging features. Radiology 171:419–425CrossRefPubMedGoogle Scholar
  21. 21.
    Turgut M, Çullu E, Şendur ÖF, Gürer G (2004) Brucella spine infection: four case reports. Neurol Med Chir (Tokyo) 44:562–567CrossRefGoogle Scholar
  22. 22.
    Madkour MM, Sharif HS, Abed MY, Al-Fayez MA (1988) Osteoarticular brucellosis: results of bone scintigraphy in 140 patients. AJR Am J Roentgenol 150:1101–1105CrossRefPubMedGoogle Scholar
  23. 23.
    Bahar RH, Al-Suhaili AR, Mousa AM, Nawaz MK, Kaddah N, Abdel Dayem HM (1988) Brucellosis: appearance on skeletal imaging. Clin Nucl Med 13:102–106CrossRefPubMedGoogle Scholar
  24. 24.
    Savvas I, Chatziioannou S, Pneumaticos SG, Zormpala A, Sipsas NV (2013) Fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography/computed scan contributes to the diagnosis and management of brucellar spondylodiskitis. BMC Infect Dis 13:73CrossRefGoogle Scholar
  25. 25.
    Goktepe AS, Alaca R, Mohur H, Coskun U (2003) Neurobrucellosis and a demonstration of its involvement in spinal roots via magnetic resonance imaging. Spinal Cord 41:574–576CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Ahmet Tuncay Turgut
    • 1
    Email author
  • Recep Brohi
    • 2
  • Pelin Demir
    • 3
  • Andrea Elefante
    • 4
  1. 1.Department of RadiologyHacettepe University School of MedicineAnkaraTurkey
  2. 2.Department of NeurosurgeryAnkara Training and Research HospitalAnkaraTurkey
  3. 3.Department of RadiologyNumune Training and Research HospitalAnkaraTurkey
  4. 4.Department of Advanced Biomedical Sciences“Federico II” UniversityNaplesItaly

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