Brucella spondylitis with paraspinal and psoas muscle abscess a case report
- Author:
SONG Minghui
;
ZUO Huifen
;
CHEN Dongke
- Publication Type:Case Reports
- Keywords:
Brucella;
brucellar spondylitis;
paravertebral abscess;
bloodstream infection;
lumbar disc herniation
- From:
China Tropical Medicine
2024;24(11):1429-
- CountryChina
- Language:Chinese
-
Abstract:
This paper analyzes a patient's clinical and laboratory characteristics with lumbar disc herniation invaded by Brucella in the bloodstream, causing brucellar spondylitis with paravertebral and psoas abscesses in Hebei Province in 2022. A 50-year-old male patient presented with lower back pain two months after physical exertion, and the symptoms were alleviated after bed rest but recurred intermittently. A Lumbar CT scan indicated disc protrusion, and the patient experienced multiple episodes of fever during this period. Twelve days before admission, the patient developed unexplained swelling pain and numbness in the right lower limb, which persisted despite bed rest. On October 21, 2022, tissue and abscess specimens were directly cultured and Gram-stained, along with blood culture, Brucella antibody testing, and CT imaging. Gram staining of the pus sample revealed tiny, sand-like bacterial bodies, suspected to be Brucella species. Paravertebral abscess samples and positive blood cultures were cultured on blood agar plates, yielding Brucella melitensis. Brucella antibody tests were positive. CT scanning of the lumbar vertebrae revealed bone destruction from L3 to L5, with swelling of the paravertebral soft tissues and left psoas muscle. The patient was diagnosed with brucellar spondylitis, with the accompanying paravertebral and psoas abscesses being a rare complication of brucellar spondylitis. Conservative treatment was ineffective, so surgery was performed to relieve nerve compression symptoms, along with the administration of anti-Brucella medication. The patient was discharged 15 days and continued anti-Brucella treatment post-discharge. One year follow-up showed the patient was cured with no recurrence. Brucellosis is characterized by sporadic outbreaks, with atypical clinical symptoms that can easily result in missed or incorrect diagnoses. Timely blood cultures are crucial for early diagnosis and effective anti-Brucella treatment to prevent disease progression and dissemination through the bloodstream, which could lead to multiple organ involvement, exacerbating the condition and hindering recovery.
- Full text:202511121031450375722.Brucella spondylitis with paraspinal and psoas muscle abscess a case report.pdf
