General
- Brucella is another bacterium that can cause spondylodiscitis in endemic areas with many differentiating features from other organisms
Pathophysiology
- Zoonotic disease frequently found in farmers, butchers, or veterinarians who work with animals
- Infects via direct exposure to skin/mucosa, inhalation of aerosols, or consumption of contaminated dairy products
Clinical Features
- Predilection for sacroiliac joint and lumbar spine
- Slowly progressive long-standing symptoms with subacute presentation (unlike pyogenic spondylodiscitis)
- May have elevated transaminases and hepatosplenomegaly
Diagnosis
- Brucella serology has quick turnaround with high sensitivity and specificity
- MRI shows less aggressive picture than pyogenic spondylodiscitis
- Frequently shows involvement of anterior superior end plate, especially in early stages
Treatment
- At least 3 months of doxycycline with streptomycin or rifampicin
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