Brucellosis Spinal Epidural Abscess: A Case Series of Fourteen Patients

Abstract

Objective: In the present study, we aimed to describe the clinical features, diagnosis, treatment and prognosis of Brucellosis spinal epidural abscess (BSEA). Methods: The complete clinical data of 14 BSEA patients who were treated in our hospital system from January 2014 to February 2019 were retrospectively analyzed. Moreover, the clinical features, diagnosis, treatment and prognosis of 60 BSEA cases collected from the English literature from 1994 to 2019 were also investigated. Results: 3 cases were positive for blood culture, 6 cases were positive for Brucella latex agglutination test, and 9 cases were positive for tissue culture. All 14 cases showed focal spinal pain, 11 cases showed neurological deficits, and 7 cases showed fever. Of the 14 cases, 12 involved the lumbosacral spine and 2 involved the cervical spine. 13 cases were cured, 1 case left limb numbness, and the follow-up time was 12-20 months. Conclusion: The classic diagnosis of triad (focal spinal pain, neurological deficit and fever) is less specific for the diagnosis of BSEA. MRI examination can find epidural abscess, brucella latex agglutination test, blood culture, tissue culture and biopsy can be used for etiological diagnosis. Brucellosis is an uncommon cause of epidural abscess. For BSEA, early detection, early diagnosis, and early treatment should be performed, and the most suitable treatment method should be selected through comprehensive evaluation.