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September 24, 1960

Brucellosis of the Bones and JointsExperience with Thirty-Six Patients

JAMA. 1960;174(4):347-353. doi:10.1001/jama.1960.03030040001001

Among the 36 cases of brucellosis here reported there were 22 in which the diagnosis was based on actual culture of brucellar organisms and 14 in which it was based on serologic evidence alone. Twenty-nine patients were farmers, and the others had all come into contact somehow with meat or milk from infected herds. The course of brucellar osteomyelitis was chronic and it was the hardest of all lesions to treat successfully. Secondary invading organisms often appeared and sometimes persisted after cultures had become negative for Brucella. Spondylitis was frequent, and in 11 cases it was destructive. Most patients were treated with streptomycin and either tetracycline or sulfadiazine, vestibular function being tested periodically to detect early signs of injury to the eighth cranial nerve. For patients with brucellosis of the bones and joints the authors recommend aggressive surgical treatment.