Brucellar spondylodiscitis in a case with spondylolisthesis

Abstract

Abstract. Spondylodiscitis with epidural abscess complication in Brucella infection is quite rare. Spondylolisthesis with spondylolysis at two levels is very unusual. Herein a case of spondylodiscitis with epidural and anterior paravertebral abscess due to Brucella with spondylolytic spondylolisthesis altogether in 54-years old female, is reported. Clinical, laboratory and radiological findings of brucellar spondylodiscitis with differential diagnosis are discussed. Brucellar spondylodiscitis diagnosis was based on clinical history supported by serology and blood culture and MRI. Spondylolisthesis was demonstrated by plain radiograph and MRI. This is a unique case of brucellar spondylodiscitis along with two level spondylolytic spondylolisthesis. 

Key words: Brucella, spondylodiscitis, spondylolysis, spondylolisthesis, magnetic resonance imaging

Keywords

• Brucella, spondylodiscitis, spondylolysis, spondylolisthesis, magnetic resonance imaging

References

1. Young EJ. An overview of human brucellosis. Clin Infect Dis. 1995; 21: 283-289.
2. Tali ET. Spinal infections. Eur J Radiol 2004; 50: 120-133.
3. Solera J, Lozano E, Martínez-Alfaro E, et al. Brucellar spondylitis: review of 35 cases and literature survey. Clin Infect Dis 1999; 29: 1440- 1449.
4. al-Shahed MS, Sharif HS, Haddad MC, et al. Imaging features of musculoskeletal brucellosis. Radiographics 1994; 14: 333-348.
5. Harman M, Unal O, Onbasi KT, Kiymaz N, Arslan H. Brucellar spondylodiscitis: MRI diagnosis. Clin Imaging 2001; 25: 421-427.
6. Chelli Bouaziz M, Ladeb MF, Chakroun M, Chaabane S. Spinal brucellosis: a review. Skeletal Radiol 2008; 37: 785-790.
7. Turgut M, Turgut AT, Koşar U. Spinal brucellosis: Turkish experience based on 452 case published during the last century. Act Neurochir (Wien) 2006; 148: 1033-1044.
8. Yilmaz MH, Mete B, Kantarci F, et al. Tuberculous, brucellar and pyogenic spondylitis: comparison of magnetic resonance imaging findings and assessment of its value. South Med J 2007; 100: 613-614.

9. Tekkök IH, Berker M, Ozcan OE, Ozgen T, Akalin E. Brucellosis of the spine. Neurosurgery 1993; 33: 838-844.
10. Sharif HS, Aideyan OA, Clark DC, et al. Brucellar and tuberculous spondylitis: comparative imaging features. Radiology 1989; 171: 419-425.
11. Pourbagher A, Pourbagher MA, Savas L, et al. Epidemiologic,clinical and imaging findings in brucellosis patients with osteoarticular involvement. AJR Am J Roentgenol 2006; 187: 873-880.
12. Daglioglu E, Bayazit N, Okay O, et al. Lumbar epidural abscess caused by brucella species: report of two cases. Neurocirugia (Astur) 2009; 20: 159- 162.
13. Greenspan A. Spine. In Greenspan A. Ortopedic Radiology: A Practical Approach. (Third Edition) Lippincott Williams&Wilkins 2000, pages 379-383.