{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T21:31:55Z","timestamp":1775079115571,"version":"3.50.1"},"reference-count":60,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Human brucellosis remains a neglected zoonosis with global distribution and diverse clinical manifestations. This report describes a case of brucellar spondylodiscitis in a 35-year-old female patient from Syria, residing in Brazil for seven years, with a history of brucellosis diagnosed and treated two decades earlier. The patient presented with chronic back pain, headache, and left upper limb discomfort, with no fever or weight loss. Magnetic resonance imaging revealed a pathological fracture of the T8 vertebral body. Histopathological examination showed a chronic granulomatous inflammatory process with fibrosis and focal necrosis, first treated as bone tuberculosis. After laboratory confirmation of brucellosis, the patient was treated with amikacin, rifampicin, and doxycycline for nine months, showing clinical, radiological, and laboratory improvement. This case highlights the importance of considering brucellosis as a differential diagnosis for spondylodiscitis, even many years after initial infection, especially in patients with relevant epidemiological history.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0421","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T18:00:18Z","timestamp":1771351218000},"page":"644-647","source":"Crossref","is-referenced-by-count":0,"title":["Brucellar Spondylodiscitis 20 Years Post Infection"],"prefix":"10.4269","volume":"114","author":[{"given":"Mar\u00edlia","family":"Kanebley","sequence":"first","affiliation":[{"name":"Instituto de Infectologia Em\u00edlio Ribas, S\u00e3o Paulo State Department of Health, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamal Muhamad Abdul","family":"Hamid Suleiman","sequence":"additional","affiliation":[{"name":"Instituto de Infectologia Em\u00edlio Ribas, S\u00e3o Paulo State Department of Health, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suely Sanae","family":"Kashino","sequence":"additional","affiliation":[{"name":"Instituto Adolfo Lutz, S\u00e3o Paulo State Department of Health, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rene Leandro","family":"Magalh\u00e3es Rivero","sequence":"additional","affiliation":[{"name":"Instituto de Infectologia Em\u00edlio Ribas, S\u00e3o Paulo State Department of Health, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evandro","family":"Sobroza de Mello","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Sao Paulo School of Medicine, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorlan","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil;"},{"name":"Faculdade de Ci\u00eancias Biol\u00f3gicas e da Sa\u00fade, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elba Regina Sampaio","family":"de Lemos","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos Vinicius","family":"da Silva","sequence":"additional","affiliation":[{"name":"Instituto de Infectologia Em\u00edlio Ribas, S\u00e3o Paulo State Department of Health, S\u00e3o Paulo, Brazil;"},{"name":"Pontifical Catholic University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Rev Bras Med Trab","first-page":"62","article-title":"Exposi\u00e7\u00e3o acidental \u00e0 vacina da brucelose","volume":"9","author":"Hyeda","year":"2011"},{"key":"b2","series-title":"Microorganisms","first-page":"942","article-title":"Facing the human and animal brucellosis conundrums: The forgotten lessons","volume":"10","author":"Moreno","year":"2022"},{"key":"b3","series-title":"World J Orthop","first-page":"54","article-title":"Osteoarticular manifestations of human brucellosis: A review","volume":"10","author":"Esmaeilnejad-Ganji","year":"2019"},{"key":"b4","series-title":"North Clin Istanb","first-page":"415","article-title":"Current therapeutic strategy in osteoarticular brucellosis","volume":"6","author":"Unuvar","year":"2019"},{"key":"b5","series-title":"Clin Infect Dis","first-page":"e135","article-title":"The many faces of human-to-human transmission of brucellosis: Congenital infection and outbreak of nosocomial disease related to an unrecognized clinical case","volume":"45","author":"Mesner","year":"2007"},{"key":"b6","series-title":"Lancet Infect Dis","first-page":"91","article-title":"The new global map of human brucellosis","volume":"6","author":"Pappas","year":"2006"},{"key":"b7","series-title":"Int J Infect Dis","first-page":"e469","article-title":"Clinical manifestations and complications in 1,028 cases of brucellosis: A retrospective evaluation and review of the literature","volume":"14","author":"Buzgan","year":"2010"},{"key":"b8","series-title":"Rev Sci Tech","first-page":"249","article-title":"Economics of brucellosis impact and control in low-income countries","volume":"32","author":"McDermott","year":"2013"},{"key":"b9","series-title":"J Prev Med Hyg","first-page":"E635","article-title":"The incidence and geographical distribution of brucellosis in Iran using geographic information system and prediction of its incidence in 2021","volume":"62","author":"Khazaei","year":"2021"},{"key":"b10","series-title":"J Infect Dev Ctries","first-page":"1185","article-title":"Epidemiological study of human brucellosis among febrile patients in Erbil-Kurdistan region, Iraq","volume":"16","author":"Almashhadany","year":"2022"},{"key":"b11","series-title":"J Infect","first-page":"85","article-title":"Multivariate model for predicting relapse in human brucellosis","volume":"36","author":"Solera","year":"1998"},{"key":"b12","series-title":"Bull Exp Biol Med","first-page":"223","article-title":"Comparison of different laboratory methods for clinical detection of Brucella infection","volume":"172","author":"Suo","year":"2021"},{"key":"b13","series-title":"Microorganisms","first-page":"1260","article-title":"Immunosuppressive mechanisms in brucellosis in light of chronic bacterial diseases","volume":"10","author":"Pellegrini","year":"2022"},{"key":"b14","series-title":"Am J Pathol","first-page":"1505","article-title":"Pathogenesis and immunobiology of brucellosis","volume":"185","author":"de Figueiredo","year":"2015"},{"key":"b15","series-title":"Infect Dis (Lond)","first-page":"321","article-title":"A review of the immunopathogenesis of brucellosis","volume":"51","author":"Amjadi","year":"2019"},{"key":"b16","series-title":"Infection","first-page":"823","article-title":"The current therapeutical strategies in human brucellosis","volume":"49","author":"Bosilkovski","year":"2021"},{"key":"b17","series-title":"J Trop Pediatr","first-page":"fmab114","article-title":"Bacteremic and nonbacteremic brucellosis in children in Turkey","volume":"68","author":"\u00d6zdem","year":"2022"},{"key":"b18","series-title":"Ann Diagn Pathol","first-page":"151910","article-title":"Pathological features of Brucella spondylitis: A single-center study","volume":"58","author":"Ma","year":"2022"},{"key":"b19","series-title":"Clin Infect Dis","first-page":"1440","article-title":"Brucellar spondylitis: Review of 35 cases and literature survey","volume":"29","author":"Solera","year":"1999"},{"key":"b20","series-title":"Clin Microbiol Infect","first-page":"O75","article-title":"Update on treatment options for spinal 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findings","volume":"10","author":"Ozaksoy","year":"2001"},{"key":"b25","series-title":"Rev Soc Bras Med Trop","first-page":"469","article-title":"Espondilodiscite por brucelose: relato de caso","volume":"40","author":"Mello","year":"2007"},{"key":"b26","series-title":"Rev Soc Bras Med Trop","first-page":"255","article-title":"Espondilodiscite brucel\u00f3sica: relato de caso","volume":"35","author":"Ferreira","year":"2002"},{"key":"b27","series-title":"J Clin Microbiol","first-page":"922","article-title":"Serial kinetics of the antibody response against the complete Brucella melitensis ORFeome in focal vertebral brucellosis","volume":"50","author":"Cannella","year":"2012"},{"key":"b28","series-title":"Expert Rev anti Infect Ther","first-page":"109","article-title":"Therapeutic options for human brucellosis","volume":"6","author":"Al-Tawfiq","year":"2008"},{"key":"b29","series-title":"Drug Des Devel Ther","first-page":"4733","article-title":"Clinical effect of doxycycline combined with compound sulfamethoxazole and rifampicin in the treatment of brucellosis spondylitis","volume":"15","author":"Yang","year":"2021"},{"key":"b30","series-title":"PLoS Med","first-page":"e317","article-title":"Perspectives for the treatment of brucellosis in the 21st century: The Ioannina recommendations","volume":"4","author":"Ariza","year":"2007"},{"key":"b1","series-title":"Rev Bras Med Trab","first-page":"62","article-title":"Exposi\u00e7\u00e3o acidental \u00e0 vacina da brucelose","volume":"9","author":"Hyeda","year":"2011"},{"key":"b2","series-title":"Microorganisms","first-page":"942","article-title":"Facing the human and animal brucellosis conundrums: The forgotten lessons","volume":"10","author":"Moreno","year":"2022"},{"key":"b3","series-title":"World J Orthop","first-page":"54","article-title":"Osteoarticular manifestations of human brucellosis: A review","volume":"10","author":"Esmaeilnejad-Ganji","year":"2019"},{"key":"b4","series-title":"North Clin Istanb","first-page":"415","article-title":"Current therapeutic strategy in osteoarticular brucellosis","volume":"6","author":"Unuvar","year":"2019"},{"key":"b5","series-title":"Clin Infect Dis","first-page":"e135","article-title":"The many faces of human-to-human transmission of brucellosis: Congenital infection and outbreak of nosocomial disease related to an unrecognized clinical case","volume":"45","author":"Mesner","year":"2007"},{"key":"b6","series-title":"Lancet Infect Dis","first-page":"91","article-title":"The new global map of human brucellosis","volume":"6","author":"Pappas","year":"2006"},{"key":"b7","series-title":"Int J Infect Dis","first-page":"e469","article-title":"Clinical manifestations and complications in 1,028 cases of brucellosis: A retrospective evaluation and review of the literature","volume":"14","author":"Buzgan","year":"2010"},{"key":"b8","series-title":"Rev Sci Tech","first-page":"249","article-title":"Economics of brucellosis impact and control in low-income countries","volume":"32","author":"McDermott","year":"2013"},{"key":"b9","series-title":"J Prev Med Hyg","first-page":"E635","article-title":"The incidence and geographical distribution of brucellosis in Iran using geographic information system and prediction of its incidence in 2021","volume":"62","author":"Khazaei","year":"2021"},{"key":"b10","series-title":"J Infect Dev Ctries","first-page":"1185","article-title":"Epidemiological study of human brucellosis among febrile patients in Erbil-Kurdistan region, Iraq","volume":"16","author":"Almashhadany","year":"2022"},{"key":"b11","series-title":"J Infect","first-page":"85","article-title":"Multivariate model for predicting relapse in human brucellosis","volume":"36","author":"Solera","year":"1998"},{"key":"b12","series-title":"Bull Exp Biol Med","first-page":"223","article-title":"Comparison of different laboratory methods for clinical detection of Brucella infection","volume":"172","author":"Suo","year":"2021"},{"key":"b13","series-title":"Microorganisms","first-page":"1260","article-title":"Immunosuppressive mechanisms in brucellosis in light of chronic bacterial diseases","volume":"10","author":"Pellegrini","year":"2022"},{"key":"b14","series-title":"Am J Pathol","first-page":"1505","article-title":"Pathogenesis and immunobiology of brucellosis","volume":"185","author":"de Figueiredo","year":"2015"},{"key":"b15","series-title":"Infect Dis (Lond)","first-page":"321","article-title":"A review of the immunopathogenesis of brucellosis","volume":"51","author":"Amjadi","year":"2019"},{"key":"b16","series-title":"Infection","first-page":"823","article-title":"The current therapeutical strategies in human brucellosis","volume":"49","author":"Bosilkovski","year":"2021"},{"key":"b17","series-title":"J Trop Pediatr","first-page":"fmab114","article-title":"Bacteremic and nonbacteremic brucellosis in children in 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Imaging","first-page":"719","article-title":"Magnetic resonance imaging findings of musculoskeletal brucellosis","volume":"38","author":"Bozgeyik","year":"2014"},{"key":"b23","series-title":"Spine J","first-page":"2509","article-title":"Comparison of brucellar and tuberculous spondylodiscitis patients: Results of the multicenter \u201cBackbone-1 Study\u201d","volume":"15","author":"Erdem","year":"2015"},{"key":"b24","series-title":"Eur Spine J","first-page":"529","article-title":"Brucellar spondylitis: Magnetic resonance imaging (MRI) findings","volume":"10","author":"Ozaksoy","year":"2001"},{"key":"b25","series-title":"Rev Soc Bras Med Trop","first-page":"469","article-title":"Espondilodiscite por brucelose: relato de caso","volume":"40","author":"Mello","year":"2007"},{"key":"b26","series-title":"Rev Soc Bras Med Trop","first-page":"255","article-title":"Espondilodiscite brucel\u00f3sica: relato de caso","volume":"35","author":"Ferreira","year":"2002"},{"key":"b27","series-title":"J Clin Microbiol","first-page":"922","article-title":"Serial kinetics of the antibody response against the complete Brucella melitensis ORFeome in focal vertebral brucellosis","volume":"50","author":"Cannella","year":"2012"},{"key":"b28","series-title":"Expert Rev anti Infect Ther","first-page":"109","article-title":"Therapeutic options for human brucellosis","volume":"6","author":"Al-Tawfiq","year":"2008"},{"key":"b29","series-title":"Drug Des Devel Ther","first-page":"4733","article-title":"Clinical effect of doxycycline combined with compound sulfamethoxazole and rifampicin in the treatment of brucellosis spondylitis","volume":"15","author":"Yang","year":"2021"},{"key":"b30","series-title":"PLoS Med","first-page":"e317","article-title":"Perspectives for the treatment of brucellosis in the 21st century: The Ioannina recommendations","volume":"4","author":"Ariza","year":"2007"}],"container-title":["The American Journal of Tropical Medicine and 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