{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:05:04Z","timestamp":1787843104950,"version":"build-2784847793"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study evaluates the diagnostic value of etiological and serological testing and the clinical characteristics of spine brucellosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 200 cases of spine brucellosis diagnosed between 2012 and 2025, alongside 200 non-infected controls. Bacterial cultures, clinical features, serological results (Standard Agglutination Test [SAT] and Rose Bengal Test [RBT]), and imaging findings were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 200 patients with spinal involvement,\n                      <jats:italic>Brucella melitensis<\/jats:italic>\n                      was confirmed via bacterial culture in 29 cases (14.5%), with spinal tissue culture demonstrating the highest diagnostic yield (58.6%, 17\/29) and a median detection time of 3 days. Spinal brucellosis constituted 25% of all brucellosis cases, exhibiting a male predominance (76.5%) and a mean patient age of 52.2 \u00b1 10.1 years. The median hospital stay was 14.7 \u00b1 7.8 days, while the median duration of chronic spinal brucellosis was 4.4 months (IQR: 1.5\u201311.5). The lumbar spine was the most frequently involved site (78.3%), followed by the cervical (8.6%) and thoracic (5.1%) regions. CT imaging revealed characteristic lesions, including bone destruction (53.0%), intervertebral space stenosis (38.5%), disc herniation (22.0%), degenerative changes (4.5%), and osteomyelitis (1.0%). Diagnostic sensitivity varied significantly across methods: blood culture (48.0%, 12\/25), lumbar tissue culture (65.4%, 17\/26), SAT(91.3%, 157\/172), and RBT(95.9%, 165\/172). Notably, all 15 serologically false-negative cases (7 by RBT and 15 by SAT) occurred in male patients. ROC curve analysis identified C-reactive protein (CRP) as a robust biomarker, with a cutoff of 1.21 mg\/L yielding 85.2% sensitivity and 71.7% specificity (Z = 6.167, p &amp;lt; 0.001). Multivariable regression identified female sex (OR = 2.44, 95% CI: 1.20\u20134.96) and lumbar involvement (OR = 1.61, 95% CI: 0.75\u20133.46) as independent predictors of chronicity (p &amp;lt; 0.05). All patients received standard 3-month combination therapy with doxycycline and rifampicin, with surgical intervention required in 45.5% (91\/200) of cases. Clinical outcomes were favorable across the cohort, with rare reports of severe complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Brucella Spondylitis, typically chronic and lumbar-predominant, presents with bone destruction, gap stenosis, and disc herniation on imaging. Diagnosis relies on lumbar tissue culture, SAT, RBT, and CT. Early diagnosis and combined medical-surgical management improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1638298","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:36:18Z","timestamp":1761197778000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical and diagnostic insights into Brucella spondylitis: a comprehensive retrospective 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