1/7. Brucellar spinal epidural abscess.Spinal epidural abscesses account for approximately one of every 10, 000 admissions to tertiary hospitals. The midthoracic vertebrae are the most frequently affected, whilst the cervical spine is involved in fewer patients. staphylococcus aureus is identified as the cause in most cases of epidural abscess; other bacteria responsible include gram-negative bacteria, streptococcus species and Brucella species. We report the case of a patient with cervical spondylodiscitis at level C4-C5 and an epidural abscess which was compressing the spinal cord and the retropharyngeal space. The previous symptoms of brucellosis were atypical. We discuss the clinical manifestations, diagnosis, treatment and prognosis of the case.- - - - - - - - - - ranking = 1keywords = spondylodiscitis (Clic here for more details about this article) |
2/7. Brucellar spinal epidural abscess of cervical location: report of four cases.Spinal epidural abscesses account for 1 or 2 of every 10,000 hospital admissions, staphylococcus aureus being the bacterium most frequently involved. brucellosis is a disorder of worldwide distribution, relatively frequent in south america and in Mediterranean countries in europe and africa. Whilst in the USA only 200 cases are reported every year, in spain it is the most frequent zoonosis. This systemic disease seldom produces spondylodiscitis which in a minority of cases may be complicated by spinal epidural abscesses, in general of lumbar location. The purpose of this article is to analyse 4 cases of brucellar spinal epidural abscess of cervical location and diagnosed in the Province of Teruel, spain, an endemic area for the disease, through 10 consecutive years (1990-1999). We consider noteworthy the following facts: the first case was a technical employee who acquired the infection in our laboratory of microbiology, the second presented with an extensive purulent collection invading prevertebral and retropharyngeal regions, the third case was cured only with antibiotics without residual deficits. In the fourth case we were not able to demonstrate spondylodiscitis accompanying the epidural abscess at the C2-C6 levels. We discuss especially the epidemiological aspects of brucellosis, the existence of epidural abscess without spondylodiscitis, the clinical manifestations, the diagnosis by means of magnetic resonance imaging, specific serological tests for Brucella, antibiotic treatment and the prognosis of our cases.- - - - - - - - - - ranking = 3keywords = spondylodiscitis (Clic here for more details about this article) |
3/7. Brucellar spondylodiscitis in the lumbar region.A 59-year-old male farmer presented with a rare case of spondylodiscitis as a manifestation of systemic brucellosis. The patient presented with radicular pain and restricted mobility of the spine due to localized muscle spasm in addition to systemic complaints. magnetic resonance imaging demonstrated discovertebral involvement at the L4-5 intervertebral space, indicating infectious spondylodiscitis. The Rose-Bengal test was positive and the serum antibody titer was 1/1280. The patient was treated with streptomycin combined with tetracycline plus rifampicin, with complete recovery. early diagnosis is important and prompt antibrucellar chemotherapy is effective in most cases. Therefore, spondylodiscitis due to brucellosis should be considered in the differential diagnosis of spinal infections.- - - - - - - - - - ranking = 7keywords = spondylodiscitis (Clic here for more details about this article) |
4/7. A case of brucella spondylodiscitis with extended, multiple-level involvement.brucellosis is a zoonosis that affects several organs and has a protean presentation. The authors report the case of a 61-year-old male patient with brucellar spondylodiscitis involving several vertebrae and a paravertebral abscess localized in the erector spinae muscle. Diagnosis was made by positive blood culture and MRI. No relapse was seen with a combined treatment (doxycycline/rifampin) for 3 months, followed by doxycycline alone for 6 months. Almost all radiologic findings disappeared at the end of a 1-year follow-up without any further treatment.- - - - - - - - - - ranking = 5keywords = spondylodiscitis (Clic here for more details about this article) |
5/7. Lumbosacral spinal epidural abscess caused by brucella melitensis.Spinal epidural abscess is a rare condition that can lead to irreversible complications and death if untreated. Rarely, brucella melitensis may produce spondylodiscitis, which may be complicated by spinal epidural abscess. We report a case of lumbosacral spinal epidural abscess caused by brucella melitensis. Spinal brucellosis should be kept in mind in the differential diagnosis of low back pain.- - - - - - - - - - ranking = 1keywords = spondylodiscitis (Clic here for more details about this article) |
6/7. Could remembering the prozone phenomenon shorten our diagnostic journey in brucellosis? A case of Brucella spondylodiscitis.We reviewed a case of Brucella spondylodiscitis admitted to a referral, university hospital, in Ankara, turkey. A 75-year-old female was referred to our hospital with low back pain. Previous magnetic resonance imaging yielded cortical destruction of T9-10 and T12-L2 vertebral bodies, focal infectious foci at discs within this range, significant microabscesses at paravertebral areas, which lead to the diagnosis of spondylodiscitis. history of consumption of unpasteurized dairy products led us to first suspect brucellosis yet, the serum agglutination test and blood culture were negative and did mislead us to several other, sometimes invasive, diagnostic tests. The final diagnosis was reached by culturing the specimen obtained through fine-needle aspiration from the paravertebral microabscesses. The exhausting diagnostic journey that started with the suspicion of tuberculosis or malignancy ended with a diagnosis of brucellosis. brucellosis should be considered in all patients with osteoarthritic complaints in endemic regions, and the "prozone phenomenon" should be kept in mind, before proceeding to high-tech lab tests, imaging, or invasive procedures.- - - - - - - - - - ranking = 6keywords = spondylodiscitis (Clic here for more details about this article) |
7/7. Brucellar spondylodiscitis: noncontiguous multifocal involvement of the cervical, thoracic, and lumbar spine.brucellosis is a zoonosis of worldwide distribution presenting with a wide clinical spectrum. brucellosis can involve any organ or system. The axial skeleton is the most common site of involvement with a frequency ranging from 2% to 53%. Multiple-level spinal involvements are rare. This report describes the first case of noncontiguous synchronous multifocal involvement of all cervical, thoracic, and lumbar regions in a patient with brucellar spondylodiscitis.- - - - - - - - - - ranking = 5keywords = spondylodiscitis (Clic here for more details about this article) |