Spinal Brucellosis: A Case Report and Review of the Literature.

Abstract

Introduction:The most common location of infection of brucellosis is the musculoskeletal system. It is estimated that the spine is involved in 2–54% of brucellosis infections, with the lumbar spine most commonly affected. We report an uncommon case of brucellar spondylodiscitis, in addition to the pathology, common presentation, and management of spinal brucellosis through additional literature review.Case Report:A 65-year-old Hispanic male presented to an orthopedic spine surgeon with signs and symptoms concerning for metastatic disease to the spine. Investigation revealed that the patient had the rare diagnosis of brucellar spondylodiscitis. This only became apparent after detailed questioning of the patient’s history revealed his employment within a Mexican meat slaughterhouse and a regular consumer of unpasteurized Mexican cheeses.Conclusion:Although uncommon, brucellosis spondylodiscitis should remain as a differential diagnosis in any patient who presents with back pain and fever. Detailed history taking and thorough physical examination remain vital in the work-up of brucellar spondylodiscitis. Understanding the pathology, radiographic findings, and necessary work-up are essential to properly treat this infection.