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Clinical characteristics of human brucellosis in patients with various monoarticular involvements

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Abstract

The aim of the study was to determine the main demographic, epidemiological, clinical characteristics, and outcome in patients with various types of brucellar monoarticular involvement. Retrospectively, we analyzed medical histories of 331 patients with brucellar monoarticular involvement who were treated at the infectious diseases departments in Prilep, Shtip, and Veles, Republic of Macedonia, during the period 1990–2012. Their data were compared accordingly to the affected joint (sacroiliac, hip, knee, ankle, wrist, and shoulder).Patients with shoulder arthritis were significantly the oldest (mean ± standard deviation [SD] 46.0 ± 14.5 years) whereas sacroiliitis and hip arthritis were present predominantly in younger patients (mean ± SD 28.7 ± 14.1 and 28.3 ± 18.3 years, respectively) (p = 0.014). Shoulder arthritis duration was significantly the longest (mean ± SD 24.5 ± 12.4 days), and wrist arthritis duration was significantly the shortest (mean ± SD 4.1 ± 2.5 days) (p < 0.001), before establishing the diagnosis of brucellosis. With appropriate treatment, the need for restitution of the joint impairment was significantly longer when sacroiliitis and hip arthritis were present (mean ± SD 32.8 ± 23.0 and 24.6 ± 12.5 days, respectively) (p < 0.001). The relapses were noted in 14.5, 14, 16.5, 5.5, 6, and 5.5 % of the patients with sacroiliitis, hip-, shoulder-, knee-, ankle-. and wrist arthritis, respectively. In endemic areas, brucellosis should be included in the differential diagnostic consideration in patients with monoarticular involvement. Knee-, ankle-, and wrist arthritis seem to be more benign and with appropriate treatment result in short duration and satisfactory outcome. On the other hand, the involvement of sacroiliac, hip-, and shoulder joint deserves more serious approach due to longer arthritis duration and higher frequency of relapses.

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Authors and Affiliations

  1. Medical Faculty “Ss Cyril and Methodius” University, ul “Bozidar Adzija” br. 18/1-6 1000, Skopje, Republic of Macedonia

    Mile Bosilkovski, Vesna Kotevska & Nikola Labacevski

  2. Department for Infectious Diseases, Medical Center Prilep, Prilep, Republic of Macedonia

    Marjan Zezoski

  3. Department for Infectious Diseases, Medical Center Shtip, Shtip, Republic of Macedonia

    Dijana Siskova

  4. Department for Infectious Diseases, Medical Center Veles, Veles, Republic of Macedonia

    Silvana Miskova

  5. Institute for Microbiology, Skopje, Republic of Macedonia

    Vesna Kotevska

  6. Institute for Clinical Pharmacology, Skopje, Republic of Macedonia

    Nikola Labacevski

Authors
  1. Mile Bosilkovski
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  2. Marjan Zezoski
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  3. Dijana Siskova
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  4. Silvana Miskova
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  5. Vesna Kotevska
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Correspondence to Mile Bosilkovski.

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The study was approved by the institutional review boards and has been performed in accordance with the Declaration of Helsinki and its later amendments.

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Bosilkovski, M., Zezoski, M., Siskova, D. et al. Clinical characteristics of human brucellosis in patients with various monoarticular involvements. Clin Rheumatol 35, 2579–2584 (2016). https://doi.org/10.1007/s10067-016-3207-z

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  • DOI: https://doi.org/10.1007/s10067-016-3207-z

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