Brucella spondylodiscitis that affected both cervical and lumbar spines: a rare case report from Syria

• Published in: Annals of medicine and surgery Vol. 86; no. 4; pp. 2154 - 2157
• Main Authors: Alhusseini, Ayham, Hamsho, Suaad, Sleiay, Mouhammed, Alsmoudi, Hasan, Frzat, Ayham, Alabdullah, Hadi, Tawashi, Yamama
• Format: Journal Article
• Language: English
• Published: England Lippincott Williams & Wilkins 01-04-2024
• Subjects: Case Reports; brucella; spondylodiscitis; brucellosis; neurobrucellosis
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1097/MS9.0000000000001715

Brucellosis, the most common microbial zoonotic disease in the world, is endemic in both industrialized and underdeveloped countries. Between 2 and 53% of patients with brucellosis, patients develop spondylitis, and people between the ages of 50 and 60 are the most commonly affected. It mostly affects the lumbar vertebrae (L4 and L5 in particular) and the thoracic vertebrae.
A 52-year-old patient was brought to the neurological clinic after complaining of lower back discomfort, reduced mobility, and lower extremity weakness for 6 weeks. Both the cervical and lumbar columns were the sites of the specific discomfort. MRI showed cervical and lumbar discitis.
A high titre of anti-brucella antibodies was found by serology testing. He was treated with oral doxycycline (100 mg, two times daily), rifampicin (900 mg) orally once daily, and gentamicin (400 mg) once daily. The patient had massive improvement after 3 months of treatment.
This case should serve as a reminder to healthcare providers to keep a high index of suspicion for uncommon infections, including Brucella species, in patients exhibiting discitis symptoms, especially when traditional microbiological gram stain and culture are negative.