Analysis of Brucellosis Spondylitis Misdiagnosed as Spinal Tuberculosis in 12 Patients

JIANG Wen; SUN Jian-hua; CAO Cheng-zhang; CHEN Lei; LI Jiang-hua

doi:10.3969/j.issn.1002-3429.2017.06.002

Abstract：Objective To analyze clinical characteristics and causes of brucellosis spondylitis misdiagnosed as spinal tuberculosis in order to improve levels of diagnosis and treatment.Methods Clinical data of 12 patients with brucellosis spondylitis admitted during May 2014 and May 2016, who were misdiagnosed as having spinal tuberculosis, was retrospectively analyzed.Results The misdiagnosed rate was 30% in this group, and average misdiagnosed time was (7.86±2.30) d.Among the 12 patients, 5 patients were misdiagnosed as having tuberculosis of thoracic spine;3 patients were misdiagnosed as having tuberculosis of lumbar spine;3 patients were misdiagnosed as having tuberculous cervical spondylitis;1 patient was misdiagnosed as having cervical and lumbar tuberculosis.Brucellosis spondylitis was confirmed combination of MRI, tuberculin test and brucella agglutination test results, and 8 patients were treated with anti-brucella and anti-infective treatments;4 patients received surgeries and symptomatic treatments, and then patients were discharged after conditions were improved.The patients had good prognosis and no recurrence during 3 months to 2 years of follow-up.Conclusion Clinicians should take into account the possibility of brucella spondylitis for patients having clinical manifestations such as low back pain and fever and ineffective anti-TB treatment, and related examinations should be performed as early as possible to reduce misdiagnosis rate.