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. 1990 Dec;49(12):994–998. doi: 10.1136/ard.49.12.994

Brucella arthritis: a study of 96 cases in Kuwait.

M I Khateeb 1, G F Araj 1, S A Majeed 1, A R Lulu 1
PMCID: PMC1004295  PMID: 2270973

Abstract

Of 400 patients with brucellosis, 104 (26%) had arthritis, of whom 96 could be followed up. The systemic disease in the 96 patients was acute in 54 (56%), subacute in 24 (25%), and chronic in 18 (19%). The main presenting symptoms were joint pain, fever, sweating, and easy fatigability. The joints most commonly affected were the sacroiliac joint (26%) and knee (25%) followed by hip (18%) and spine (8%). There was no particular pattern of joint affection in relation to age. Joint effusion occurred in 32/104 (30%) of cases, predominantly (94%) in the acute group. Culture of synovial fluid was negative in all, and analysis of synovial fluid for cellular profile, glucose, and protein content was not particularly helpful in diagnosis. Plain radiographs did not show major pathological changes. Among the laboratory tests, including haematological and liver function tests, the brucella enzyme linked immunosorbent assay (ELISA) was the most reliable in the diagnosis of disease, using serum and synovial fluid specimens. Treatment with a combination of streptomycin plus tetracyclines or rifampicin resulted in an excellent cure rate and resolution of arthritis without sequelae or mortality. Thus brucellosis should be considered in the differential diagnosis of arthritis, especially in areas in which the disease is endemic.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Al-Rawi Z. S., Al-Khateeb N. Clinical features of first attack of rheumatic fever in adults. Rheumatol Rehabil. 1982 Nov;21(4):195–200. doi: 10.1093/rheumatology/21.4.195. [DOI] [PubMed] [Google Scholar]
  2. Alarcón G. S., Bocanegra T. S., Gotuzzo E., Espinoza L. R. The arthritis of brucellosis: a perspective one hundred years after Bruce's discovery. J Rheumatol. 1987 Dec;14(6):1083–1085. [PubMed] [Google Scholar]
  3. Alausa O. K. Brucellosis: socio-economic problems and control in various countries. Trop Geogr Med. 1980 Mar;32(1):5–11. [PubMed] [Google Scholar]
  4. Andonopoulos A. P., Asimakopoulos G., Anastasiou E., Bassaris H. P. Brucella arthritis. Scand J Rheumatol. 1986;15(4):377–380. doi: 10.3109/03009748609098207. [DOI] [PubMed] [Google Scholar]
  5. Ariza J., Gudiol F., Valverde J., Pallarés R., Fernández-Viladrich P., Rufí G., Espadaler L., Fernández-Nogues F. Brucellar spondylitis: a detailed analysis based on current findings. Rev Infect Dis. 1985 Sep-Oct;7(5):656–664. doi: 10.1093/clinids/7.5.656. [DOI] [PubMed] [Google Scholar]
  6. Bahar R. H., Al-Suhaili A. R., Mousa A. M., Nawaz M. K., Kaddah N., Abdel-Dayem H. M. Brucellosis: appearance on skeletal imaging. Clin Nucl Med. 1988 Feb;13(2):102–106. doi: 10.1097/00003072-198802000-00008. [DOI] [PubMed] [Google Scholar]
  7. Dawes P. T., Ghosh S. K. Tissue typing in brucellosis. Ann Rheum Dis. 1985 Aug;44(8):526–528. doi: 10.1136/ard.44.8.526. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. GANADO W., CRAIG A. J. Brucellosis myelopathy. J Bone Joint Surg Am. 1958 Dec;40-A(6):1380–1388. [PubMed] [Google Scholar]
  9. Goldenberg D. L., Reed J. I. Bacterial arthritis. N Engl J Med. 1985 Mar 21;312(12):764–771. doi: 10.1056/NEJM198503213121206. [DOI] [PubMed] [Google Scholar]
  10. Gotuzzo E., Alarcón G. S., Bocanegra T. S., Carrillo C., Guerra J. C., Rolando I., Espinoza L. R. Articular involvement in human brucellosis: a retrospective analysis of 304 cases. Semin Arthritis Rheum. 1982 Nov;12(2):245–255. doi: 10.1016/0049-0172(82)90064-6. [DOI] [PubMed] [Google Scholar]
  11. Gómez-Reino F. J., Mateo I., Fuertes A., Gómez-Reino J. J. Brucellar arthritis in children and its successful treatment with trimethoprim-sulphamethoxazole (co-trimoxazole). Ann Rheum Dis. 1986 Mar;45(3):256–258. doi: 10.1136/ard.45.3.256. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hodinka L., Gömör B., Merétey K., Zahumenszky Z., Géher P., Telegdy L., Bozsóky S. HLA-B27-associated spondylarthritis in chronic brucellosis. Lancet. 1978 Mar 4;1(8062):499–499. doi: 10.1016/s0140-6736(78)90158-7. [DOI] [PubMed] [Google Scholar]
  13. Jayakumar R. V., Al-Aska A. K., Subesinghe N., Wright S. G. Unusual presentation of culture positive brucellosis. Postgrad Med J. 1988 Feb;64(748):118–120. doi: 10.1136/pgmj.64.748.118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Julkunen H. Reactive arthritis. Bull Rheum Dis. 1978;29(9):1002–1005. [PubMed] [Google Scholar]
  15. KELLY P. J., MARTIN W. J., SCHIRGER A., WEED L. A. Brucellosis of the bones and joints. Experience with thirty-six patients. JAMA. 1960 Sep 24;174:347–353. doi: 10.1001/jama.1960.03030040001001. [DOI] [PubMed] [Google Scholar]
  16. Lawrence J. S. Relationship of infection to rheumatoid factor in the population. Ann Rheum Dis. 1970 Mar;29(2):196–197. doi: 10.1136/ard.29.2.196-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lifeso R. M., Harder E., McCorkell S. J. Spinal brucellosis. J Bone Joint Surg Br. 1985 May;67(3):345–351. doi: 10.1302/0301-620X.67B3.3997939. [DOI] [PubMed] [Google Scholar]
  18. Lubani M., Sharda D., Helin I. Brucella arthritis in children. Infection. 1986 Sep-Oct;14(5):233–236. doi: 10.1007/BF01644269. [DOI] [PubMed] [Google Scholar]
  19. Madkour M. M., Sharif H. S., Abed M. Y., Al-Fayez M. A. Osteoarticular brucellosis: results of bone scintigraphy in 140 patients. AJR Am J Roentgenol. 1988 May;150(5):1101–1105. doi: 10.2214/ajr.150.5.1101. [DOI] [PubMed] [Google Scholar]
  20. Majeed H. A., Yousof A. M., Khuffash F. A., Yusuf A. R., Farwana S., Khan N. The natural history of acute rheumatic fever in Kuwait: a prospective six year follow-up report. J Chronic Dis. 1986;39(5):361–369. doi: 10.1016/0021-9681(86)90122-0. [DOI] [PubMed] [Google Scholar]
  21. Manès G. Epidemiological situation of brucellosis in the Mediterranean countries. Dev Biol Stand. 1984;56:739–747. [PubMed] [Google Scholar]
  22. Matyas Z., Fujikura T. Brucellosis as a world problem. Dev Biol Stand. 1984;56:3–20. [PubMed] [Google Scholar]
  23. Norton W. L. Brucellosis and rheumatic syndromes in Saudi Arabia. Ann Rheum Dis. 1984 Dec;43(6):810–815. doi: 10.1136/ard.43.6.810. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Porat S., Shapiro M. Brucella arthritis of the sacro-iliac joint. Infection. 1984 May-Jun;12(3):205–207. doi: 10.1007/BF01640901. [DOI] [PubMed] [Google Scholar]

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