J Korean Orthop Assoc.  2007 Feb;42(1):136-140. 10.4055/jkoa.2007.42.1.136.

Clinical Findings of Brucellar Spondylitis: A Case Report

• Shim DM
• Park JY

• KMID: 2106387
• DOI: http://doi.org/10.4055/jkoa.2007.42.1.136

Abstract

Brucellosis is an endemic zoonotic disease that it is rare in Korea. However, there have been regional increases in its prevalence. Brucellar spondylitis is difficult to diagnose because the clinical presentation is often variable and nonspecific. Therefore, it is often overlooked in a differential diagnosis of back pain. A culture and microbiologic study is the choice for diagnosing brucellar spondylitis. If treatment is not properly done, brucellar spondylitis can result in severe complications including neurobrucellosis. Medical treatments for brucellar spondylitis are generally encouraged, even though surgical treatments are performed in cases showing spinal instability caused by progressive spinal cord and root compression. The combination of doxycycline and streptomycin for 3 weeks followed by a combination of doxycycline and rifampicin for 6 months is the most effective regimen. We report a case of brucellar spondylitis to highlight it as one of the possible cause of back pain in Korea.

Keyword

Brucellosis; Spondylitis

MeSH Terms

Back Pain
Brucellosis
Diagnosis, Differential
Doxycycline
Korea
Prevalence
Rifampin
Spinal Cord
Spondylitis*
Streptomycin
Zoonoses
Doxycycline
Rifampin
Streptomycin

Figure

• 

  Fig. 1 (A) X-ray shows L3 destructive lesion in the upper endplate. (B) Bone scan shows an abnormal increased uptake in the L3 body and SI joint.

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  Fig. 2 Brucellar Spondylodiscitis involving T10, L2, 3 with paraspinal small abscess. Formation T2 weighted MR sagittal image shows increase signal intensity in the T10, L2, 3 bodies. (B) T1 weighted MR sagittal image shows low signal intensity. (C) On Gadolinium enhancement, the lesion, which was low in the T1 image, showed strong contrast enhancement. (D) Gadolinium enhancement coronal section view. Relatively spared intervertebral disc.

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  Fig. 3 MR axial image in the L3 vertebral upper body level. A, B, C in order of T2, T1, Gadolinium weighted image shows soft tissue enhancement area extended to the anterolateral aspect forming a small abscess.

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