Abstract
Giriş ve Önemi: Bruselloz dünyada, özellikle sanayileşmiş ve az gelişmiş ülkelerde en sık görülen zoonotik hastalıklardan biridir. Klinik tablo genellikle lokal olmakla birlikte multisistemik olgular da görülebilmektedir. Multisistemik vakalarda, genellikle brusellozlu hastaların %2 ila %53'ünde spondilit gelişir ve en sık etkilenen yaş grubu 50 ila 60 yaş arasındaki kişilerdir. Bu klinik tablo çoğunlukla lomber vertebraları (L4 ve L5) ve torakal vertebraları etkilemektedir.
Vaka Sunumu: Olgudan bir ay önce (Bruselloz tanısı konulduğu gün itibariyle) Lomber Disk Hernisi (LDH) nedeniyle beyin cerrahı tarafından ameliyat edilen 55 yaşındaki erkek hasta, şiddetli bel ve sağ bacak ağrısı şikayetiyle tekrar beyin cerrahi kliniğine başvurdu. İleri derecede hareket kısıtlılığı bulunan hastaya yapılan serolojik Bruselloz testlerinde pozitif sonuç tespit edildi. Hastanın öyküsünde son dört haftadır hareket kabiliyetinde azalma ve alt ekstremitede güçsüzlük olduğu öğrenildi. Manyetik Rezonans Görüntülemede (MRG) lomber kolonlarda, tanısal olarak önemli olan bölgeler (granülomatöz alanlar) ve lomber diskitin bulunduğu yerler anlamlıydı.
Klinik Tartışma: Bruselloz spesifik seroloji testlerinde pozitif tarama testi sonucu ve yüksek titrede anti-brusella antikorları bulundu. Hastaya klinisyen tarafından uygun antibiyotik tedavisi (üçlü antibiyotik tedavisi) uygulandı. Hasta şifa ile taburcu edildi.
Sonuç: Bruselloz; lokal (eklem ağrısı, artrit gibi) veya sistemik bulgularla (spondilodiskit, tenosinovit gibi) karşımıza çıkabilen bir enfeksiyon hastalığıdır. Bu olguda olduğu gibi; benzer klinik ve semptomatik özelliklere sahip hastalarda bruselloz gibi zoonotik bir hastalığın varlığının mutlaka araştırılması gerektiği hatırlanmalıdır.
Ethical Statement
Conflict of Interest Statement: There is no financial conflict of interest with any institution, organization or person related to this study and there is no conflict of interest between the authors. Ethics Statement: This study includes studies that do not require ethics committee approval; data collection from data obtained through surveys, group studies, focus studies, observations, experiments, interviews, all kinds of research conducted with qualitative or beautiful treatments, humans and animals (including material data) are used with universal or scientific data, parts performed on humans are not within the scope of those performed on animals, and are included in retrospective transactions in accordance with Data Protection), and it has been declared that no ethical transactions have been carried out regarding this personal law. Funding: The authors declared that they received no financial support for this study.
References
- • Al Jindan, R. (2021). Scenario of pathogenesis and socioeconomic burden of human brucellosis in Saudi Arabia. Saudi J Biol Sci, Jan, 28(1), 272-279. doi: 10.1016/j.sjbs.2020.09.059. Epub 2020 Oct 9. PMID: 33424306; PMCID: PMC7783673.
- • Alhusseini, A., Hamsho, S., Sleiay, M., Alsmoudi, H., Frzat, A., Alabdullah, H., Tawashi, Y. (2024). Brucellaspondylodiscitis that affected both cervical and lumbar spines: A rare case report from Syria. Ann Med Surg (Lond), Jan 11, 86(4), 2154-2157. doi: 10.1097/MS9.0000000000001715. PMID: 38576911; PMCID: PMC10990348.
- • Ali Adam, A., Sheikh Hassan, M., Adam Osman, A. (2022). Spinal brucellosis causing spondylodiscitis. Ann Med Surg (Lond), Sep 23, 82, 104782. doi: 10.1016/j.amsu.2022.104782. PMID: 36268353; PMCID: PMC9577941.
- • Alton, G, G., Forsyth, J, R, L. (1996). Brucella, In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 28. Available from:https://www.ncbi.nlm.nih.gov/books/NBK8572/.
- • Di Bonaventura, G., Angeletti, S., Ianni, A., Petitti, T., Gherardi, G. (2021). Microbiological laboratory diagnosis of human brucellosis: An overview. Pathogens, Dec, 14; 10(12), 1623. doi: 10.3390/pathogens10121623. PMID: 34959578; PMCID: PMC8709366.
- • Laine, C, G., Johnson, V, E., Scott, H, M., Arenas-Gamboa, A, M. (2023). Global estimate of human brucellosis incidence. Emerg Infect Dis, Sep, 29(9), 1789-1797. doi: 10.3201/eid2909.230052. PMID: 37610167; PMCID: PMC10461652.
- • Rizkalla, J, M., Alhreish, K., Syed, I. Y. (2021). Spinal brucellosis: A case report and review of the literature. J Orthop Case Rep, Mar, 11(3),1-5. doi: 10.13107/jocr.2021.v11.i03.2060. PMID: 34239818; PMCID: PMC8241257.
- • Spernovasilis, N., Karantanas, A., Markaki, I., Konsoula, A., Ntontis, Z., Koutserimpas, C., Alpantaki, K. 2024). Brucella spondylitis: Current knowledge and recent advances. J Clin Med, Jan, 19, 13(2), 595. doi: 10.3390/jcm13020595. PMID: 38276100; PMCID: PMC10816169.
- • Yagupsky, P., Morata, P., Colmenero, J. D. (2019). Laboratory diagnosis of human brucellosis. Clin Microbiol Rev, Nov 13, 33(1), e00073.
Abstract
Introduction and importance: Brucellosis is one of the most common zoonotic diseases in the world, especially in industrialized and underdeveloped countries. Although the clinical picture is usually local, multisystemic cases can also be seen. In multisystemic cases, generally, 2% to 53% of patients with brucellosis develop spondylitis and the most commonly affected age group is people between 50 and 60 years of age. This clinical picture mostly affects the lumbar vertebrae (L4 and L5) and thoracic vertebrae.
Case presentation: A 55-year-old male patient, who was operated on by a neurosurgeon for Lumbar Disc Herniation (LDH) 1 month before the case (the day of Brucellosis diagnosed), was re-admitted to the neurosurgery clinic with complaints of severe waist and right leg pain. A positive result was detected in the serological Brucellosis tests performed on the patient with severe mobility limitations. The patient's history included decreased mobility and lower extremity weakness for the past 4 weeks. In Magnetic Resonance Imaging (MRI), diagnostically important regions (granulomatous areas) and locations of lumbar discitis in the lumbar columns were significant.
Clinical discussion: In Brucellosis specific serology tests, a positive screening test result and high titer anti-brucella antibodies were found. Appropriate antibiotic treatment was given to the patient by the clinician (triple antibiotic therapy). The patient was discharged with full recovery.
Conclusions: This phenomenon; it should be reminded that a zoonotic disease such as Brucellosis should always be investigated for patients with similar clinical and symptomatic features. In particular, it should not be forgotten that in microbiological studies of patients with a history of spondylodiscitis, gram staining and bacteriological culture studies are mostly negative.
Keywords
References
- • Al Jindan, R. (2021). Scenario of pathogenesis and socioeconomic burden of human brucellosis in Saudi Arabia. Saudi J Biol Sci, Jan, 28(1), 272-279. doi: 10.1016/j.sjbs.2020.09.059. Epub 2020 Oct 9. PMID: 33424306; PMCID: PMC7783673.
- • Alhusseini, A., Hamsho, S., Sleiay, M., Alsmoudi, H., Frzat, A., Alabdullah, H., Tawashi, Y. (2024). Brucellaspondylodiscitis that affected both cervical and lumbar spines: A rare case report from Syria. Ann Med Surg (Lond), Jan 11, 86(4), 2154-2157. doi: 10.1097/MS9.0000000000001715. PMID: 38576911; PMCID: PMC10990348.
- • Ali Adam, A., Sheikh Hassan, M., Adam Osman, A. (2022). Spinal brucellosis causing spondylodiscitis. Ann Med Surg (Lond), Sep 23, 82, 104782. doi: 10.1016/j.amsu.2022.104782. PMID: 36268353; PMCID: PMC9577941.
- • Alton, G, G., Forsyth, J, R, L. (1996). Brucella, In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 28. Available from:https://www.ncbi.nlm.nih.gov/books/NBK8572/.
- • Di Bonaventura, G., Angeletti, S., Ianni, A., Petitti, T., Gherardi, G. (2021). Microbiological laboratory diagnosis of human brucellosis: An overview. Pathogens, Dec, 14; 10(12), 1623. doi: 10.3390/pathogens10121623. PMID: 34959578; PMCID: PMC8709366.
- • Laine, C, G., Johnson, V, E., Scott, H, M., Arenas-Gamboa, A, M. (2023). Global estimate of human brucellosis incidence. Emerg Infect Dis, Sep, 29(9), 1789-1797. doi: 10.3201/eid2909.230052. PMID: 37610167; PMCID: PMC10461652.
- • Rizkalla, J, M., Alhreish, K., Syed, I. Y. (2021). Spinal brucellosis: A case report and review of the literature. J Orthop Case Rep, Mar, 11(3),1-5. doi: 10.13107/jocr.2021.v11.i03.2060. PMID: 34239818; PMCID: PMC8241257.
- • Spernovasilis, N., Karantanas, A., Markaki, I., Konsoula, A., Ntontis, Z., Koutserimpas, C., Alpantaki, K. 2024). Brucella spondylitis: Current knowledge and recent advances. J Clin Med, Jan, 19, 13(2), 595. doi: 10.3390/jcm13020595. PMID: 38276100; PMCID: PMC10816169.
- • Yagupsky, P., Morata, P., Colmenero, J. D. (2019). Laboratory diagnosis of human brucellosis. Clin Microbiol Rev, Nov 13, 33(1), e00073.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Patient Safety |
| Journal Section | Article |
| Authors | |
| Publication Date | May 28, 2025 |
| Submission Date | December 3, 2024 |
| Acceptance Date | April 21, 2025 |
| Published in Issue | Year 2025 Volume: 22 Issue: 2 |
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