Cervical Spondylitis and Epidural Abscess Caused by Brucellosis: a Case Report and Literature Review

Abstract

Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae. Epidural abscess may occur as a rare complication of spondylitis. Spinal brucellosis and development of epidural abscess in the cervical region are rare. Development of epidural abscess affects the duration and success of treatment. Spinal brucellosis should be considered in patients presenting with fever and lower back-neck pain in endemic regions, and treatment must be initiated with early diagnosis in order to prevent potential complications.

Extensive Cervical Epidural Abscess: Case Report

“…Hyperintense signal in the MRI, obliteration of the subarachnoid space and mild cord compression were observed [6]. Infectious or tumoural causes and complications secondary to trauma, tuberculous spondylitis, and brucellosis may be considered in differential diagnosis [7,8]. Laboratory investigations were also done like random, fasting and post prandial blood glucose level for detection of diabetes mellitus as immunosuppressed patients are more susceptible for spinal abscesses and osteomyelitis.…”

“…CRP level was 150. White blood cells count was 11.800 Treatment options include antibiotic therapy and surgical drainage [6,8,9].…”

Imaging-Based Approach to Extradural Infections of the Spine

“…Brucellosis is a highly contagious zoonosis caused by ingesting unpasteurized milk or undercooked meat from infected animals 67 . This gram negative bacillus is endemic to parts of the Mediterranean basin.…”

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

“…The musculoskeletal exhibitions in-clude arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis, and bursitis. Among them, spondylitis and spondylodiscitis are predominant and affect lumbar and thoracic vertebra (9). The average age of spondylitis onset has been reported to be 40 years with no sex pattern (10,11).…”