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[Spondylodiscitis cause by Brucella suis]

G D Kant¹, J H van Lijf, R P Karthaus

¹Afd. Interne Geneeskunde, Medisch Spectrum Twente, Enschede.

Nederlands Tijdschrift Voor Geneeskunde

|December 24, 1994

Summary

Brucella suis spondylodiscitis in a Dutch patient led to a paraspinal abscess. Initial antibiotics failed, but doxycycline and streptomycin showed improvement, yet a relapse and death occurred.

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Area of Science:

Infectious Diseases
Bacteriology
Clinical Medicine

Background:

Brucella suis infection can cause severe spondylodiscitis and paraspinal abscesses.
Surgical drainage is a common intervention for complicated spinal infections.

Observation:

A 72-year-old male presented with Brucella suis spondylodiscitis (TXII-LI) and a paraspinal abscess, requiring surgical drainage.
The patient initially received a combination antibiotic regimen including doxycycline, rifampicin, and trimethoprim-sulfamethoxazole without recovery.

Findings:

Clinical improvement was observed after switching to doxycycline and streptomycin.
A relapse occurred after a 9-week symptom-free period, leading to the patient's death at home after refusing further treatment.

Implications:

This case highlights the challenges in treating Brucella suis spondylodiscitis, even with appropriate surgical and antibiotic interventions.
The potential for relapse underscores the need for careful monitoring and potentially prolonged treatment courses.
Transmission from handling wild boar carcasses suggests a zoonotic risk that warrants public health awareness.

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