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Journal of Medical Case Reports

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Open Access 01-12-2022 | Doxycycline | Case report

Noncontiguous multifocal Brucella spondylodiscitis with paravertebral abscess: a case report

Authors: Sarah Gerges, Alessandro Khoury, Souheil Hallit, Fadi Hoyek, Rabih Hallit

Published in: Journal of Medical Case Reports | Issue 1/2022

Abstract

Background

Human brucellosis is the most frequently contracted zoonotic infection worldwide. Although being an old disease that carries minimal risks of mortality, it remains a source of considerable sequelae and disability. However, noncontiguous multifocal spinal involvement is an exceptional presentation of brucellosis; additionally, an associated paravertebral abscess is extremely rare.

Case presentation

This paper focuses on a 67-year-old Lebanese woman with noncontiguous multifocal Brucella spondylodiscitis, involving the T12–L1 and L3–L4 segments, with paravertebral abscess formation. She presented with a 3-week history of acute severe lumbar back pain, radiating to the lower extremities and associated with impaired mobility and lower extremity weakness. The patient complained of night sweating but had no fever. No lymphadenopathy, hepatomegaly, or splenomegaly could be observed. She had painful percussion of the lumbar spine, painful passive mobilization, and paravertebral tenderness, yet her neurological examination was completely normal. BrucellaCapt test was positive at a titer of 1/5120 (reference range 1/180). The patient was treated with an inpatient regimen for 2 weeks, which was followed by an outpatient oral antibiotic regimen with doxycycline, rifampin, and ciprofloxacin to complete a total treatment duration of 3 months. Magnetic resonance imaging was performed at the end of the treatment and showed a complete resolution of the paravertebral abscess.

Conclusion

Noncontiguous multifocal Brucella spondylodiscitis with paravertebral abscess is an extremely rare presentation. It may be effectively managed by antibiotic therapy, without surgery or drainage, in the absence of neurological complications. Nonetheless, the principal challenge to an efficient management is establishing the diagnosis of Brucella in the first place. In endemic countries, a strong suspicion of spinal involvement of brucellosis should be elicited in front of back pain presentations—even in the absence of fever and other related symptoms.

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Title: Noncontiguous multifocal Brucella spondylodiscitis with paravertebral abscess: a case report
Authors: Sarah Gerges
Alessandro Khoury
Souheil Hallit
Fadi Hoyek
Rabih Hallit
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Doxycycline
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Spondylodiscitis
Back Pain
Back Pain
Back Pain
Published in: Journal of Medical Case Reports / Issue 1/2022
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-022-03544-y

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Noncontiguous multifocal Brucella spondylodiscitis with paravertebral abscess: a case report

Abstract

Background

Case presentation

Conclusion

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Springer Medicine

Abstract

Background

Case presentation

Conclusion

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