Case Report

A Case of Brucella Spondylodiscitis with Extended, Multiple-level Involvement

Authors: Mehmet Ozden, MD, Kutbettin Demirdag, MD, Ahmet Kalkan, MD, Huseyin Ozdemir, MD, Pinar Yuce, MD

Abstract

Brucellosis is a zoonosis that affects several organs and has a protean presentation. The authors report the case of a 61-year-old male patient with brucellar spondylodiscitis involving several vertebrae and a paravertebral abscess localized in the erector spinae muscle. Diagnosis was made by positive blood culture and MRI. No relapse was seen with a combined treatment (doxycycline/rifampin) for 3 months, followed by doxycycline alone for 6 months. Almost all radiologic findings disappeared at the end of a 1-year follow-up without any further treatment.


Key Points


* Brucellosis is a zoonosis that is commonly seen throughout the world and is endemic in Turkey. Since it affects several organs and tissues, it may appear in various clinical pictures.


* This report describes a rare case of spondylodiscitis with extended involvement at seven consecutive levels.


* No relapse was observed with a combined treatment for 3 months, followed by doxycycline alone for 6 months.


* All radiologic findings improved at the end of 1 year of follow-up without any treatment in this case.

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References

1. Young EJ. An overview of human brucellosis. Clin Infect Dis 1995;21:283–290.
 
2. Tekkok IH, Berker M, Ozcan OE, et al. Brucellosis of the spine. Neurosurgery 1993;33:838–844.
 
3. Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine 1996;75:195–211.
 
4. Colmenero JD, Cisneros JM, Orjuela DL, et al. Clinical course and prognosis of Brucella spondylitis.Infection 1992;20:38–42.
 
5. Mousa AR, Muhtaseb SA, Almudallal DS, et al. Osteoarticular complications of brucellosis: a study of 169 cases. Rev Infect Dis 1987;9:531–543.
 
6. Ariza J, Gudiol F, Valverde J, et al. Brucellar spondylitis: a detailed analysis based on current findings. Rev Infect Dis 1985;7:656–664.
 
7. Mousa AM, Bahar RH, Araj GF, et al. Neurological complications of brucella spondylitis. Acta Neurol Scand 1990;81:16–23.
 
8. Khateeb MI, Araj GF, Majeed SA, et al. Brucella arthritis: a study of 96 cases in Kuwait. Ann Rheum Dis 1990;49:994–998.
 
9. Solera J, Lozano E, Martinez-Alfaro E, et al. Brucellar spondylitis: review of 35 cases and literature survey. Clin Infect Dis 1999;29:1440–1449.
 
10. Sharif HS, Aideyan OA, Clark DC, et al. Brucellar and tuberculous spondylitis: comparative imaging features. Radiology 1989;171:419–425.
 
11. Zormpala A, Skopelitis E, Thanos L, et al. An unusual case of brucellar spondylitis involving both the cervical and lumbar spine. Clin Imaging 2000;24:273–275.
 
12. Lifeso RM, Harder E, McCorkell SJ. Spinal brucellosis. J Bone Joint Surg Br 1985;67:345–351.
 
13. Ozgocmen S, Ardicoglu A, Kocakoc E, et al. Paravertebral abscess formation due to brucellosis in a patient with ankylosing spondylitis. Joint Bone Spine 2001;68:521–524.
 
14. Ariza J, Gudiol F, Pallares R, et al. Treatment of human brucellosis with doxycycline plus rifampin or doxycycline plus streptomycin: a randomized, double-blind study. Ann Intern Med 1992;117:25–30.