Brucellar spondylitis: a rare cause of spinal cord compression

Abstract

Study design: A case report. Objectives: To present and discuss some of the difficulties in the diagnosis of brucellar spondylitis. Setting: Ankara University, Ibni Sina Hospital, Turkey. Methods: We report a patient with paraplegia, misdiagnosed as having a malignancy or tuberculosis who actually suffered from brucellar spondylitis. Diagnosis was established by her history and a compatible clinical picture together with a standard tube agglutination (Wright test) titer of X1/160 of antibodies for brucellosis. The patient was treated with oral doxycycline, rifampicin, and ciprofloxacin combination. Results: At the end of the treatment, the blood Brucella Wright and anti-human globulin T titer levels decreased. Her lower limb weakness improved. She could walk, and climb stairs with the help of a cane. Urinary retention and fecal incontinence also resolved. Conclusion: Brucellosis is a systemic infection involving the musculoskeletal and nervous systems. Spondylitis frequently occurs in elderly patients. An early diagnosis of brucellar spondylitis can often be difficult. In endemic regions, as in the case of our country, brucellar spondylitis should always be considered in the differential diagnosis of older patients with back pain and constitutional symptoms. An early diagnosis will help to prevent the development of more severe complications such as spinal cord compression.

Brucellar Spondylitis in Kermanshah as an Endemic Area in West of Iran

“…In the present study, back pain (100%), fever (81%), chills (84%), and weakness (78%) were the most common symptoms, similar to the results presented by Koubaa et al that pointed to back pain, fever, and sweating (21). Persisting back pain (29), neck pain, high fever (13), sweating, and lower limb weakness (14) were also mentioned in case reports.…”

Brucellosis

“…Hemopoietik sistem tutlumu sonucu anemi, (hipokrom-mikrositer) lökopeni, trombositopeni, akut vakalarda ise pansitopeni görülür. Lenfadenopati lokalize ya da generalize olabilir (16)(17)(18) . Bruselloz özellikle febril ve toksik seyrettiği vakalarda makülopapüler/eritematöz deri döküntüleri yapabilir.…”

Cervical brucellar spondylitis presenting with prevertebral mass simulating malignancy

“…To the Editor: Brucellosis, a systemic zoonotic infection, is a relatively common health problem in certain parts of the world, such as our country 1–4. Involvement of various tissues and organs such as bones, joints, spleen, and liver can be seen in brucellosis.…”