Collapsed L4 Vertebral Body Caused by Brucellosis

Abstract

Brucellosis is caused by gram-negative, aerobic, non-motile, facultative, intracellular coccobacilli belonging to the genus Brucella. A 50-year-old man working as an employee was admitted to neurosurgery clinic with severe low back, radicular right leg pain and hypoesthesia in right L4-5 dermatomes for 2 months. Brucella tube agglutination (Wright) test was positive in serum sample of the patient with a titer of 1/640. Brucella melitensis was isolated from blood culture. X-ray and MRI of the lomber spine showed massive collapse of L4 vertebral body. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months. Brucellosis is a systemic zoonotic infection and still an important public health problem in many geographical parts of the world. Vertebral body collapse caused by brucellosis occurs very rarely but represents a neurosurgical emergency because of its potential for causing rapidly progressive spinal cord compression and permanent paralysis. Neurosurgeons, emergency department personnel as well as infectious disease specialists should always keep a high index of suspicion and include brucellosis in the differential diagnosis of vertebral body collapse.

Seroprevalence trend of human brucellosis and MLVA genotyping characteristics of Brucella melitensis in Shaanxi Province, China, during 2008–2020

“…Brucellosis is a globally important zoonotic disease caused by infection with Brucella spp. The etiologic agents of brucellosis are gram‐negative, non‐motile, and facultative intracellular coccobacilli that can infect a wide range of mammalian species, including humans and also some amphibians (Ekici et al., 2014; Khurana et al., 2021). Three main species, namely B. melitensis , B. abortus , and B. suis , are responsible for most human brucellosis cases in the developing world (Arenas‐Gamboa et al., 2016; Pascual et al., 2017).…”

Mean platelet volume in monitoring of brucellosis

“…Brucellosis infection spreads hematogenously to tissues and mainly affects organs rich in mononuclear phagocytes, such as the liver, the spleen, the lymph nodes and the bone marrow [1]. In humans, the disease may cause many symptoms varying from mild flu-like to severe complications on the part of the nervous system, musculoskeletal system and the heart [2].…”