Journal of Capital Medical University

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Analysis of clinical and histopathological features of brucella spondylitis and diagnostic value of novel molecular pathological techniques

Du Juan1,  Che Jialu1,  Yan Guangxuan2,  Su Dan1,  Che Nanying1*   

  1. 1. Department of Pathology, Beijing Chest Hospital Affiliated to Capital Medical University, Beijing 101149, China; 2. Department of Orthopedics, Beijing Chest Hospital Affiliated to Capital Medical University, Beijing 101149, China
  • Received:2026-01-12 Revised:2026-03-12 Online:2026-06-21
  • Supported by:
    This study was supported by the General Program of the National Natural Science Foundation of China (82472378), Prevention and Control of Emerging and Major Infectious Diseases-National Science and Technology Major Project (2025ZD01908700), Dengfeng Talents Project of Beijing Hospitals Authority (DFL20241601), and Beijing Research Ward Excellence Program (BRWE2024W042160103).

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Abstract: Objective  To analyze the clinicopathological characteristics of Brucella spondylitis (BS) and compare the pathogen detection capabilities of special staining and molecular pathology techniques, thereby providing a novel technical approach for the pathological diagnosis of BS.Methods  A retrospective analysis was conducted on the clinical data, imaging findings and histopathological features of 86 BS patients were confirmed by etiological or serological tests, who were admitted to Beijing Chest Hospital Affiliated to Capital Medical University from October 2016 to October 2025. Paraffin-embedded pathological tissue samples of these patients were subjected to Giemsa staining, weak acid-fast staining and Brucella-specific quantitative real-time polymerase chain reaction (qRT-PCR) detection.Results  Histopathological examination revealed lymphocyte and plasma cell infiltration (54.7%), eosinophil infiltration (37.2%), neutrophil infiltration (44.2%), and inflammatory granulation tissue formation (22.1%), accompanied by varying degrees of bone destruction (41.9%). In some cases, focal necrosis (12.3%), fibrous connective tissue proliferative lesions (19.8%) and sheets of histiocytes and foam cells (11.6%) were also observed, while a minority of cases showed multinucleated giant cell infiltration with granulomatous lesion formation (8.1%). The positive rate of Giemsa staining was 33.7%, and that of weak acid-fast staining was 23.3%. The results of qRT-PCR showed that 54 out of 86 cases (62.79%) were positive for Brucella-specific targets. Notably, the positive rate of IS711 (62.79%) was significantly higher than that of bcsp31 (46.51%) (P < 0.01). The combined positive detection rate of IS711 qRT-PCR and Giemsa staining was 67.44%, which was slightly higher than that of IS711 qRT-PCR alone (62.79%), without statistically significant difference (P > 0.05).Conclusion  BS presents is characterized by clinical-imaging-pathological triad. Histopathological evaluation, supplemented by special staining and molecular pathological techniques, can effectively improve the accuracy of pathological diagnosis of BS.

Key words: Brucella spondylitis, clinical characteristics, histopathology, molecular pathology, qRT-PCR, Giemsa staining

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