Acute Spinal Syndrome Due to Thoracic Vertebral Brucellosis: A Case Report

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Abstract

Introduction: Brucellosis is a zoonotic infection caused by brucella species. It is an endemic disease in the Mediterranean region. It may affect different organ systems with osteoarticular involvement in the form of peripheral arthritis, sacroiliitis and spondylitis being the most common and serious complication of the disease and it may lead to severe and irreversible sequelae. The diagnosis of brucellosis may be delayed due to the subtle nature of the illness, and it require isolation of the bacterium from blood or tissue sample for absolute diagnosis The World Health Organization guidelines for the treatment of human brucellosis discuss two regimens, both using doxycycline for a period of six weeks, in combination with either streptomycin for two to three weeks or rifampin for six weeks.

Case Presentation: We are reporting a case of a 67 year-old man with chronic mid-back pain which was misdiagnosed as muscle spasm but evolved into an acute spinal syndrome due to brucellar spondylodiscitis.

Conclusion: Physicians should keep a high index of suspicion and broad differential diagnosis of brucellosis as a cause of chronic back pain in appropriate parts of the world where it is considered as endemic infection, and should tailor regimen and duration of treatment according to the severity of the disease, clinical response and brucella titers.