Spinal brucellosis - A mimicker of spinal tuberculosis: An analysis of 10 patients from a tertiary care center in India.

Introduction: Brucellosis of the spine has emerged as a significant health concern in developing countries. Spinal brucellosis shares identical clinical and radiological features with tubercular spondylodiscitis. A wide range of nonspecific symptoms, chronicity of this disease, and tissue culture which is mostly invasive and time-consuming, pose a challenge in definitive diagnosis. In this study, we aim to report the clinical, radiological, and microbiological features of this disease and analyze the outcome of patients treated for spinal brucellosis. Materials and Methods: This retrospective study was conducted from 2018 to 2022 on confirmed cases of brucellosis of the spine who had adequate follow-up of at least 2 years after completion of treatment. Results: In this retrospective analysis, 10 patients had spinal brucellosis. All of them had presented with chronic history of low back pain for a period of 3-6 months. Occupational exposure was present in six patients (60%). Five (50%) of them underwent surgical intervention due to failed/doubtful diagnosis. Except for one patient, microbiological evidence of the infection was seen within 10 days from the tissue biopsy. All patients were treated with a triple regimen (gentamycin, doxycycline, and rifampin) for a period of 3 months as per World Health Organization protocol. All patients were healed of the disease with good functional outcome. Conclusion: Culture, either blood or tissue, is the gold standard method for diagnosis of this zoonotic disease. Only 50% of the study patients underwent surgical debridement. All patients in the study had good outcome with 3 months of antibiotic therapy.