1521. How Easy is the Differential Diagnosis Between Brucellar and Tuberculous Spondylodiscitis ?
Session: Poster Abstract Session: Clinical Infectious Diseases: Diabetic Foot Infections
Saturday, October 10, 2015
Room: Poster Hall
  • P 1521.pdf (62.7 kB)
  • Background: Spondylodiscitis is a common disease that may lead to serious vertebral sequelae. This entity has aroused a major interest in the endemic countries where M. Tuberculosis and Brucella spp are frequently involved. The aim of our study was to compare the clinical, biological, radiological and therapeutic characteristics of brucellar (BS) and tuberculous spondylodiscitis (TS).

    Methods: We studied retrospectively 87 patients hospitalized in the Department of Infectious Diseases between 1995 and 2013. They were divided into 2 groups: G1 (57 patients with TS; 65.5%) and G2 (30 patients with BS; 34.5%). Clinical, radiological and biological characteristics were collected in 2 groups as well as management and outcome features.

    Results: The mean age of patients was similarly in 2 groups (46.9±19 vs. 50.5±15 years; p=0.3). There were 25 males (43.8%) in G1 and 22 males in G2 (73.3%; p=0,009). Four TS patients had a previous history of tuberculosis (7%). Ingestion of unpasteurized milk was more frequent in G2 (43.8 vs.93.3%; p<0.0001 and OR=20). Fever and sweats were predominant in BS patients (43.8 vs. 66.7%; p=0.04 in each case). Neurological symptoms had shown no difference between 2 groups. There was no BS patient suffering from spinal cord compression (vs. 9 TS patients (15.8%); p=0.025). White blood cells counted 8154±3614 E/mm3 in G1 (vs. 6142±1832 E/mm3 in G2; p=0.001). Wright Serology was positive in all BS patients (100%). Discovertebral biopsy was performed in 36 TS patients (63.1% vs. 26.7%; p=0.001). BS involved predominantly lumbar vertebrae (45.6 vs. 83.3%; p=0.001) while dorsal level was more frequently affected in TS (54.3 vs. 26.7%; p=0.013). The mean duration of treatment was far longer in G1 (13.3± 5.8 vs. 7.5±3 months; p<0.0001). Eleven TS patients (19.3%) were referred to surgery while no BS patient needed surgical treatment (p=0.014). Sequelae were noted similarly in 2 groups (67.5 vs. 50%; p=0.1).

    Conclusion: Our study underlined the difficulty of etiological diagnosis in cases of spondylodiscitis especially in areas with a high prevalence of brucellosis. Further studies are in need to help physicians in these cases.

    Houda Ben Ayed, MD, Makram Koubaa, MD, Sahar Ben Kahla, MD, Asma Tlijani, MD, Imed Maaloul, MD, Dorra Lahiani, MD, Chakib Marrakchi, MD and Mounir Ben Jemaa, MD, Department of Infectious Diseases, Hedi Chaker University Hospital, Sfax, Tunisia


    H. Ben Ayed, None

    M. Koubaa, None

    S. Ben Kahla, None

    A. Tlijani, None

    I. Maaloul, None

    D. Lahiani, None

    C. Marrakchi, None

    M. Ben Jemaa, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.