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Related Experiment Videos

Brucellar spondylo-discitis with rapidly progressive spinal epidural abscess presenting with sciatica.

K Z Yuksel1, M Senoglu, M Yuksel

  • 1Department of Neurosurgery, Faculty of Medicine, Sutcu Imam University, Kahramanmaras, Turkey.

Spinal Cord
|May 10, 2006
PubMed
Summary

Spinal brucellosis can mimic lumbar disc herniation, leading to diagnostic delays and complications. Early recognition through serological tests is crucial for timely antibiotic treatment and preventing severe outcomes.

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Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Radiology

Background:

  • Brucellosis is a zoonotic infection endemic in many regions.
  • Spinal brucellosis can present with nonspecific symptoms, mimicking common conditions like lumbar disc herniation.
  • Delayed diagnosis of spinal brucellosis can lead to severe complications, including spinal epidural abscess.

Observation:

  • A 57-year-old woman presented with chronic low-back pain and sciatica, initially diagnosed as lumbar disc herniation.
  • Initial diagnostic workup, including a negative Rose-Bengal test and lumbar CT, was inconclusive.
  • Despite treatment for presumed disc herniation, her symptoms progressed, and MRI revealed spinal epidural abscess.

Findings:

  • A positive Rose-Bengal test confirmed brucellosis.

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  • The patient's spinal epidural abscess was successfully treated with emergent surgery and a prolonged course of antibiotics.
  • This case highlights the importance of considering brucellosis in endemic areas, even with initially nonspecific findings.

    • Implications:

    • Clinicians in brucellosis-endemic areas should maintain a high index of suspicion for spinal brucellosis in patients with persistent back pain and sciatica.
    • Prompt and appropriate serological testing is essential for early diagnosis and management of spinal brucellosis.
    • Timely diagnosis and treatment of spinal brucellosis can prevent serious neurological complications and improve patient outcomes.