Abstract
BackgroundOf the diverse presentation of neurobrucellosis, intra-medullary spinal cord abscess is extremely rare. Only four other cases have been reported so far. We present a case of spinal cord intra-medullary abscess due to Brucella melitensis.Case presentationA forty-year-old female presented with progressive weakness of both lower limb with urinary incontinence of 6 months duration. She was febrile. Neurological examination revealed flaccid areflexic paraplegia with T10 below sensory impairment including perianal region. An intramedullary mass was diagnosed on Magnetic Resonance Image (MRI) scan extending from T12 to L2. At surgery, a large abscess was encountered at the conus medullaris, from which Brucella melitensis was grown on culture. She was started on streptomycin and doxycycline for 1 month, followed by rifampicin and doxycycline for 1 month. At 2-year follow-up, she had recovered only partially and continued to have impaired bladder function.ConclusionNeurobrucellosis, if not treated early, can result in severe neurological morbidity and sequale, which may be irreversible. Hence it is important to consider the possibility of neurobrucellosis in endemic region and treat aggressively.
Highlights
Of the diverse presentation of neurobrucellosis, intra-medullary spinal cord abscess is extremely rare
It is important to consider the possibility of neurobrucellosis in endemic region and treat aggressively
We present a case of intra-medullary spinal cord abscess in which Brucella melitensis was cultured from pus
Summary
The presentation of neurobrucellosis, which encompass neuro-psychiatric disorders in brucellosis, is varied. We present a case of intra-medullary spinal cord abscess in which Brucella melitensis was cultured from pus. She had flaccid areflexic paraplegia with power 0/5 (MRC grade) She had impaired sensations in both lower limbs with a level at T10. MRI scan of the spine showed a lesion in the spinal cord extending from lower part of T12 to L2. It was hyperintense on T1WI and iso-intense on T2WI There was cord edema extending cranially up to T10 (figure 1). The organism isolated in blood culture taken preoperatively, was identified as Brucella melitensis. She had fever, headaches and vomiting lasting for about 1 week. She refused a repeat MRI scan, as she could not afford it
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Annals of clinical microbiology and antimicrobials
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
