ORIGINAL ARTICLES   

Gazzetta Medica Italiana-Archivio per le Scienze Mediche 2009 June;168(3):143-7

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

On the musculoskeletal involvement in patients with brucellosis from an endemic area

Nava A. ^{1, 6}, Riebeling-Navarro C. ², Navarrete-Navarro S. ³, Pizarro S. ⁴, Mendoza C. ⁵, García-Carrasco M. ⁵, Zavala-Trujillo I. ⁷

¹ Unit of Clinical Epidemiology, UMAE HE CMNO, University of Guadalajara, Guadalajara, Mexico 2 UIEC UMAE HP CMN-SXXI University of Guadalajara, Guadalajara, Mexico 3 UIEC UMAE HP CMNO University of Guadalajara, Guadalajara, Mexico 4 UIEC Delegación Chihuahua University of Guadalajara, Guadalajara, Mexico 5 Unit of Autoimmune Diseases Instituto Mexicano del Seguro Social, Guadalajara, Mexico 6 Health Sciences University of Guadalajara, Guadalajara, Mexico 7 Department of Infectivology University Hospital Dr. Angel Leaño Faculty of Medicine University of Guadalajara, Guadalajara, Mexico

Aim. Brucellosis is still an important public health problem throughout the world, but principally in developing countries such as Mexico. The aim of the present study was to describe frequency of musculoskeletal involvement in 14 consecutive patients with the suspect infection of brucellosis. All patients came from the brucellosis high prevalent region.
Methods. An analysis for musculoskeletal involvement was carried out on 14 consecutive patients with brucellosis. The diagnosis was supported by the isolation of a Brucella sp. or a four-fold increase in serum anti-brucella antibodies.
Results. Seven patients were females and 7 males, ranging in age from 19 to 64 years (mean 31 years). Ten patients had one or more positive cultures and anti-brucella antibodies were high prevalent. Myalgias were the most common musculoskeletal manifestation (92%), followed by polyarthralgias (71%), lumbalgia (57%), peripheral arthritis (28%) and dorsalgia (21%). Bilateral sacroiliitis was less common. In three patients with lumbalgia, the computerized tomography images were compatible with herniated intervertebral disk.
Conclusion. In this series the musculoskeletal involvement had a high prevalence. Muscle and joint pain were the main forms of clinical presentation. Peripheral arthritis and the axial involvement seem to have complications associate with functional disability. We suggest that, when in an endemic area, brucellosis had to be considered into diagnosis possibilities for musculoskeletal symptoms, even if manifestations include lumbalgia plus sciatica. In addition, surgical remotion of intervertebral disk should be delayed and reconsidered once 6 weeks of antimicrobial therapy active against brucella had been accomplished.