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[Brucellar spinal abscess. Case report]

L. Cecchini1, G. Coari, A. Iagnocco

  • 1Dipartimento di Terapia Medica, Cattedra di Reumatologia, Università degli Studi di Roma "La Sapienza", Italia.

Reumatismo
|August 9, 2002
PubMed
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Brucellosis, a zoonotic disease endemic in Mediterranean regions, can cause spinal abscesses. This case highlights unusually large spinal brucellar abscesses compressing nerve roots, diagnosed via MRI.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Radiology

Background:

  • Brucellosis is a zoonotic infection prevalent globally, particularly endemic in Mediterranean countries.
  • Transmission to humans typically occurs via contaminated food, but less commonly through skin, eyes, or inhalation.
  • While often asymptomatic, brucellosis can manifest acutely or chronically, with spinal involvement being a rare but significant localized form.

Purpose of the Study:

  • To report an unusual case of extensive spinal brucellar abscesses.
  • To emphasize the importance of considering brucellosis in endemic areas with spinal symptoms.
  • To illustrate the diagnostic utility of MRI in defining complex spinal abscesses.

Main Methods:

  • Case report of a patient presenting with symptoms suggestive of spinal pathology.

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  • Diagnostic imaging using Magnetic Resonance Imaging (MRI) to delineate the extent of the abscess.
  • Clinical and radiological correlation to confirm brucellosis as the cause.

    • Main Results:

    • The patient presented with multiple, exceptionally large spinal brucellar abscesses.
    • Abscesses extended into the epidural space and involved paravertebral and psoas muscles.
    • Significant compression of lumbar nerve roots was identified, causing neurological symptoms.

    Conclusions:

    • Spinal brucellar abscesses, though rare, can reach exceptional dimensions and cause severe complications like nerve root compression.
    • MRI is crucial for accurate localization and assessment of the extent of such abscesses.
    • High index of suspicion for brucellosis is warranted in endemic areas, especially with unexplained spinal or paravertebral masses.