Collapsed L4 Vertebral Body Caused by Brucellosis.
10.3340/jkns.2014.55.1.48
- Author:
Mehmet Ali EKICI
1
;
Zuhtu OZBEK
;
Burak KAZANCI
;
Bulent GUCLU
Author Information
1. Department of Neurosurgery, Sevket Yilmaz Training and Research Hospital, Bursa, Turkey. mehmetali.ekici@gmail.com
- Publication Type:Case Report
- Keywords:
Brucellosis;
Spinal infections;
Treatment;
Vertebral collapse
- MeSH:
Agglutination;
Brucella;
Brucella melitensis;
Brucellosis*;
Communicable Diseases;
Diagnosis, Differential;
Doxycycline;
Emergencies;
Emergency Service, Hospital;
Humans;
Hypesthesia;
Leg;
Magnetic Resonance Imaging;
Middle Aged;
Neurosurgery;
Paralysis;
Public Health;
Rifampin;
Specialization;
Spinal Cord Compression;
Spine;
Zoonoses
- From:Journal of Korean Neurosurgical Society
2014;55(1):48-50
- CountryRepublic of Korea
- Language:English
-
Abstract:
Brucellosis is caused by gram-negative, aerobic, non-motile, facultative, intracellular coccobacilli belonging to the genus Brucella. A 50-year-old man working as an employee was admitted to neurosurgery clinic with severe low back, radicular right leg pain and hypoesthesia in right L4-5 dermatomes for 2 months. Brucella tube agglutination (Wright) test was positive in serum sample of the patient with a titer of 1/640. Brucella melitensis was isolated from blood culture. X-ray and MRI of the lomber spine showed massive collapse of L4 vertebral body. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months. Brucellosis is a systemic zoonotic infection and still an important public health problem in many geographical parts of the world. Vertebral body collapse caused by brucellosis occurs very rarely but represents a neurosurgical emergency because of its potential for causing rapidly progressive spinal cord compression and permanent paralysis. Neurosurgeons, emergency department personnel as well as infectious disease specialists should always keep a high index of suspicion and include brucellosis in the differential diagnosis of vertebral body collapse.
