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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
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Cervical brucellosis mimicking cervical disc herniation.
Mehmet Tezer1, Zafer Orhan2, Cagatay Ozturk3
1Istanbul Spine Center, Florence Nightingale Hospital, Şişli, Istanbul, Turkey.
Summary
Brucellar spondylitis, a spinal infection, can mimic cervical disc herniation, leading to misdiagnosis. Early agglutination tests are crucial for accurate diagnosis in endemic areas to avoid unnecessary surgery.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Radiology
Background:
- Brucellar spondylitis is challenging to diagnose, with initial spinal radiographs often showing only mild degenerative changes.
- Magnetic resonance imaging (MRI) can be helpful but may also lead to misdiagnosis in some brucellosis cases.
- The cervical spine is a potential site for brucella infection.
Purpose of the Study:
- To report a case of brucella infection of the cervical spine misdiagnosed as cervical disc herniation.
- To highlight the diagnostic challenges and potential for surgical misadventure in brucellar spondylitis.
- To emphasize the importance of considering brucellosis in the differential diagnosis of spinal infections.
Main Methods:
- Case report presentation.
- Review of diagnostic imaging (plain radiographs, MRI).
- Discussion of clinical presentation and diagnostic workup, including brucella agglutination tests.
Main Results:
- A patient with cervical spine brucellosis was misdiagnosed with cervical disc herniation and underwent surgery.
- The clinical presentation mimicked cervical disc herniation, with severe, disabling pain.
- Brucella agglutination tests were essential for correct diagnosis.
Conclusions:
- Brucellar spondylitis requires a high index of suspicion, especially in endemic regions.
- Non-specific symptoms and imaging findings can lead to misdiagnosis and inappropriate surgical intervention.
- Prompt diagnostic investigations, including serological tests for brucellosis, are vital before initiating treatment for suspected spinal conditions.
