Three Cases of Brucellar Spondylitis with Noncontiguous Multifocal Involvement.

ABSTRACT

BACKGROUND: Brucellosis is an endemic disease. Brucellar spondylitis is mainly manifested as a unifocal lesion, but noncontiguous multifocal brucellar spondylitis is more rare. CASE DESCRIPTION Herein, we report 3 patients with noncontiguous multifocal involvement of brucellar spondylitis who are over 51 years of age. The diagnosis was established by using magnetic resonance imaging (MRI) and positive brucellar agglutination test. All patients were cured with antibrucellosis chemotherapy and surgery. For patients with a high degree of suspicion of noncontiguous multifocal brucellar spondylitis, especially elderly patients, screening with the use of serologic test for brucellosis and whole spine MRI is crucial to reduce the rate of misdiagnosis and missed diagnosis. CONCLUSIONS: Clinicians should raise awareness of noncontiguous multifocal brucellar spondylitis. The Wright agglutination test and whole spine MRI are the key methods to reduce misdiagnosis and missed diagnosis of noncontiguous multifocal brucellar spondylitis. Drug therapy for brucellar spondylitis is the basis, and surgical treatment is complementary therapy. The use of alternative chemotherapy and surgery for noncontiguous multifocal brucellar spondylitis is also safe and effective.