[Brucella spondylodiskitis].

In the light of two personal observations some epidemiological, radiological and serological aspects of brucellar spondylodiscitis are discussed. In Switzerland livestock is considered brucellosis-free, and hence spondylodiscitis has become an infectious disease imported from well known endemic brucellosis regions. The clinical picture is not very typical, except for circumscript vertebral pathology, and frequently the disease process lacks the humoral signs of inflammation and infection. Radiologically, early osseous reparative processes are characteristic, frequently with only minor destructive lesions. A tendency to spontaneous recovery is not uncommon and in fact is suggested by one of our own observations. The disease is, therefore, essentially different from tuberculous spondylitis. In only 20% of all cases can the presence of germs be shown in abscess or granulation tissue. Serologic tests provide valuable information but always point to a generic and not a specific diagnosis. Good therapeutic effects are obtained with trimethoprim-sulfamethoxazole which are possibly better than with combined therapy using tetracycline and streptomycin.