Osteoarticular manifestations of human brucellosis: A review

Single- and double-dose of platelet-rich plasma versus hyaluronic acid for treatment of knee osteoarthritis: A randomized controlled trial

Introduction: Duration of treatment for brucellar spondylitis in endemic regions is controversial. This study describes the outcome of treatment in 50 cases of brucellar spondylitis in Iran. Methodology: From April 2001 to September 2010, we treated 20, 13, 11 and 6 cases with doxycycline plus rifampin (DR), streptomycin plus doxycycline plus rifampin (SDR), cotrimoxazole plus doxycycline plus rifampin (CDR), and gentamicin plus doxycycline plus rifampin (GDR), respectively. Gentamicin and streptomycin were administered for 14 days and the other agents for 3 months. When complete clinical response was not achieved, therapy was continued. All patients were followed for one year. The Kaplan Meier method and the log rank test were used to compare the duration of therapy between SDR plus GDR patients with those treated with CDR or DR. Results: Eight (45%), 10 (76.9%), 7 (63.3%) and 6 (100%) cases treated for three months were cured with DR, SDR, CDR and GDR, respectively. Nine (45%), 4 (36.4%) and two (22.2%) were cured after four months with DR, CDR and SDR, respectively. Mean duration of therapy in the SDR plus GDR, CDR and DR was 3.26±0.17, 3.36±0.15 and 3.9±0.23 months, respectively (p=0.49 and p=0.015, respectively). Three cases with epidural or paravertebral abscesses recovered after six months. Relapse occurred in one (9.1%) and two (10%) cases treated with CDR and DR, respectively. Conclusions: Brucellar spondylitis could be treated using different combinations of antimicrobials especially with a regimen containing aminoglycoside for four months; patients with epidural or paravertebral abscesses require longer treatment times.

This prospective study was conducted on 111 children with brucellosis, who attended the Department of Infectious Diseases, Babol, Iran, from September 1999 to March 2003. Fever (73.9%), sweating (67.6%), artheralgia (49.5%) and splenomegaly (18%) were common findings. The disease was acute and sub-acute in 97.3% and chronic in 2.7% of cases. Peripheral arthritis was seen in 35 (31.5%) of cases, which was monoarticular in 29 patients, most involving the knees and hips. Sacroilitis was seen in six (5.4%) cases.