Spinal Brucellosis with Paraspinal Abscess Formation Treated with CT Guided Percutaneous Abscess Drainage

Area of Science:

• Infectious Diseases
• Orthopedics
• Neurosurgery

Background:

• Brucellosis is a systemic infection with potential for severe osteoarticular complications.
• Osteoarticular brucellosis, particularly Brucellar spondylitis (BS), can involve paravertebral and epidural abscesses, posing significant clinical challenges.
• Management of complex BS abscesses requires effective therapeutic strategies.

Purpose of the Study:

• To present two cases of Brucellar spondylitis with paraspinal abscesses and epidural extension.
• To evaluate the efficacy of percutaneous drainage techniques combined with antibrucellar chemotherapy in managing these complex cases.

Main Methods:

• Case 1: Non-complicated paraspinal abscess treated with percutaneous abscess drainage and antibrucellar chemotherapy.
• Case 2: Disseminated BS with a large, multiseptated abscess managed initially with needle drainage and medical treatment, followed by percutaneous catheter drainage (Seldinger technique) due to lack of response.

Main Results:

• Percutaneous abscess drainage and antibrucellar chemotherapy were effective in the first case.
• The second case, initially unresponsive to needle drainage, showed significant radiological and clinical improvement after percutaneous catheter drainage and continued chemotherapy.
• Both cases demonstrated successful outcomes with the applied interventional and medical treatments.

Conclusions:

• Osteoarticular brucellosis, especially with abscess formation, is a serious condition requiring prompt and effective management.
• Percutaneous drainage, particularly catheter-based techniques like the Seldinger method for complex abscesses, is a valuable adjunct to antibrucellar chemotherapy.
• Interventional radiology combined with appropriate antibiotic therapy offers a successful treatment paradigm for Brucellar spondylitis with paravertebral and epidural abscesses.