![]() In the spine, the vertebral bodies and intervertebral disk areas are the most frequently affected sites, and Brucella spondylitis or discitis with epidural abscess formation has been frequently reported. Localized brucellosis most commonly involves the bones and joints (10 to 80 % of cases), especially the axial skeleton, and results in Brucella spondylitis, sacroiliitis, and peripheral arthritis. It can involve any organ or tissue, including the eyes, liver, lungs, nervous system, cardiovascular system, bone, and joints. Effective antibiotic therapy of a sufficient duration and timely performance of surgical treatment are the key points in management of such cases.īrucellosis is an endemic and systemic disease with characteristic symptoms of undulant fever, night sweats, and weakness. This is an unusual case of Brucella infection of the vertebral arch with epidural abscess formation. Recovery was confirmed by clinical, magnetic resonance imaging, and blood culture findings. Total laminectomy, abscess cleansing, and percutaneous pedicular screw fixation was performed initially, followed by antibiotic treatment with a combination of doxycycline and rifampin for 4 months. Diagnosis of Brucella infection of his vertebral arch was confirmed by a positive blood culture with growth of Brucella melitensis. Thoracic magnetic resonance imaging showed laminar destruction of T9 and an epidural abscess at the T9 to 10 level with significant cord compression. Case presentationĪ 57-year-old man of Han nationality with a history of contact with an isolated sheep stomach 2 months previously was admitted with an undulant fever, night sweats, back pain, and weakness. We present the first case of Brucella infection of the thoracic vertebral arch with epidural abscess formation and discuss the clinical key points. Although Brucella spondylitis and Brucella discitis have been frequently reported, Brucella infection of the vertebral arch is rare and has not been previously described.
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