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ISSN 2007-8560 (Print)
Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2013, Number 3

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Ortho-tips 2013; 9 (3)

Back pain due to brucellosis

Horta CLF

Language: Spanish
References: 22
Page: 177-183
PDF size: 197.50 Kb.


ABSTRACT

Human brucellosis is a zoonotic disease, transmitted by the digestive track consumption of milk and its unpasteurized derivatives. It is a disease of world distribution that mainly affects developing countries and is caused by different species of Brucella. In its manifestations osteoarticular mainly affects the sacro iliac joint; however, it can involve the spine, hip and knee. The spondylitis occurs between 8 to 13%, and Brucella melitensis is responsible for almost all the cases with osteoarticular condition. It has a predilection for the lumbar spine and lower back pain which is considered to be one of the main clinical manifestations in both acute and chronical, in combination with fever which should be considered the symptoms with high index of suspicion of spinal spondylitis by Brucella. For the diagnosis test, it is required of agglutination in the serum ( febrile reaction). The test of Rosa de Bengala and 2-Mercaptorthanol is also counted with ELISA and polymerase chain reaction, although limited by its high cost. The X-ray images have very low sensitivity, by what the MRI studies prove to be the image of choice. The treatment consist of doxycicline 100 mg twice a day for 6 weeks combined with rimfapicin 600-900 g daily for 6 weeks or streptomycin 1 g daily for 2-3 weeks. The surgical treatment is indicated for an epidural abscess, neurological deficit, instability and it is here based on the concepts of stability, decompression, fusion and saggital balance, will be indicated to undertake the necessary procedures for each individual case.


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