Intervertebral Disk Disease Caused by the Brucella Organism

RUCELLOSIS can produce changes in the spine simulating hypertrophic osteoarthritis and the syndrome of pain in the back and sciatica. The condition has been neglected in the differential diagnosis of disk disease and may have gone unrecognized in many obscure cases of pain in the back. The purpose of this paper is to show that spondylitis caused by Brucella infection in man has its origin in a destructive granulomatosis of the intervertebral disk. This theory opposes the belief that involvement of the disk spreads from the bony matrix. The fact that in most cases the pathology in the vertebral body is fully developed together with the disk lesions has precluded the recognition of this alternative explanation, the nmre so because early localization in the bone marrow is characteristic of the Brucella organism. A recently studied case demonstrates the presence of granulomatous destruction limited to the interbody joint. Radiographic and pathologic evidence from other cases also implicates the disk in the pathogenesis of brucellar spondylitis. BRUCELLA ORGANISMS AND BRUCELLOSIS Evans, 8 recognizing the similarities in the organisms discovered by Bruce (Malta, 1887) and by Bang (Denmark, 1897), suggested the generic name to honor Bruce, who led the investigation that determined the cause of undulant fever in man. Subsequently the organism recovered from aborting sows by Traum (United States, 1914) was added to the genus. Br. melitensis, Br. abortus and