tetracycline and Spondylitis

A 33-year-old patient from former Yugoslavia presented with low back pain and fever. Plain X-rays and myelography were normal, but a technetium-99m scan was suspect for vertebral osteomyelitis. Serology and blood cultures were positive for Brucella (melitensis). Antibiotic therapy with tetracycline and rifampicine rapidly improved the signs and symptoms of the infection. A retrospective analysis of 11 cases of Brucellosis treated in the Kantonsspital, Chur, over the years 1973 to 1992 revealed that 9 patients were foreign workers from rural areas in the Mediterranean region (Spain, Portugal, Italy, Yugoslavia, Greece). The majority had a history of consuming milk and dairy products from their own farm animals up to a few months before the onset of symptoms. Blood cultures were positive in 5 cases (B. melitensis) while the remaining 6 had high titers of agglutinating antibodies. A diagnostic delay of several weeks to months was typical. Because Brucellosis usually presents with unspecific often flu-like symptoms, with unspecific laboratory findings, and with a varying array of organ manifestations a high index of suspicion is essential for a timely diagnosis.

Topics: Adolescent; Adult; Brucella melitensis; Brucellosis; Diagnostic Imaging; Emigration and Immigration; Female; Humans; Male; Retrospective Studies; Rifampin; Rural Population; Spondylitis; Switzerland; Tetracycline

Two patients are described in whom arthritis following intestinal bypass surgery for obesity was associated with the presence of circulating immune complexes (CLC) and HLA B27. The arthritis was characteristically intermittent and controlled by low dose prednisone, indomethacin, and tetracycline therapy. The findings suggest that immune complexes play a role in the pathogenesis of arthritis associated with condition, and that perhaps the association with HLA B27 may predispose to the development of this complication.

Topics: Adolescent; Arthritis; Female; Histocompatibility Antigens; HLA Antigens; Humans; Immune Complex Diseases; Indomethacin; Intestine, Small; Male; Obesity; Prednisone; Radiography; Spondylitis; Tetracycline

Topics: Animals; Brucella; Brucellosis; Dog Diseases; Dogs; Intervertebral Disc; Lumbar Vertebrae; Male; Osteomyelitis; Radiography; Sacrum; Spondylitis; Tetracycline; Thoracic Vertebrae

Topics: Abscess; Anti-Bacterial Agents; Brucellosis; Chlortetracycline; Humans; Physiology; Protein Synthesis Inhibitors; Radiography; Spondylitis; Streptomycin; Tetracycline