The case reported is the fifty-seventh case of spondylitis complicating undulant fever to be recorded. Brucella suis was isolated from the blood stream soon after the development of the local lesion, which occurred over a year after the initial infection. The lesion in the lumbar region was treated by surgical fusion, and the cervical lesions, by support, with improvement after seven months.
The clinical appearance is the result of the hematogenous localization of bacteria, ordinarily in the osseous marrow, but exceptionally in the disc in young individuals. The roentgenographic findings demonstrate a spreading process of the infiltrative type in which there is a reactive phenomenon, proliferative in nature, and characterized by endosteal and periosteal reaction. The result is sclerosis of the body with hypertrophic spur formation. There is little tendency to invasion of the paravertebral tissues.
This complication originates usually in the convalescent stage of undulant fever, but may make its appearance at any time. It is accompanied by a febrile reaction, and is characterized by the acuteness of the symptoms and a benign clinical course.
The treatment is medical and surgical. Recovery is the rule.
(C) 1939 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.