Brucellar spondylitis: a rare cause of spinal cord compression.
METHODS
A case report.


OBJECTIVE
To present and discuss some of the difficulties in the diagnosis of brucellar spondylitis.


METHODS
Ankara University, Ibni Sina Hospital, Turkey.


METHODS
We report a patient with paraplegia, misdiagnosed as having a malignancy or tuberculosis who actually suffered from brucellar spondylitis. Diagnosis was established by her history and a compatible clinical picture together with a standard tube agglutination (Wright test) titer of > or =1/160 of antibodies for brucellosis. The patient was treated with oral doxycycline, rifampicin, and ciprofloxacin combination.


RESULTS
At the end of the treatment, the blood Brucella Wright and anti-human globulin T titer levels decreased. Her lower limb weakness improved. She could walk, and climb stairs with the help of a cane. Urinary retention and fecal incontinence also resolved.


CONCLUSIONS
Brucellosis is a systemic infection involving the musculoskeletal and nervous systems. Spondylitis frequently occurs in elderly patients. An early diagnosis of brucellar spondylitis can often be difficult. In endemic regions, as in the case of our country, brucellar spondylitis should always be considered in the differential diagnosis of older patients with back pain and constitutional symptoms. An early diagnosis will help to prevent the development of more severe complications such as spinal cord compression.
Tur
B Sonel
BS
Department of Physical Medicine and Rehabilitation, School of Medicine, Ankara University, Turkey.
Suldur
N
N
Ataman
S
S
Ozturk
E A
EA
Bingol
A
A
Atay
M B
MB
D000368:Aged; D000900:Anti-Bacterial Agents; D002006:Brucellosis / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D003611:Dairy Products / Q000009:adverse effects; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007738:Kyphosis / Q000382:microbiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010264:Paraplegia / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D012698:Serologic Tests; D013117:Spinal Cord Compression / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology; D013125:Spinal Neoplasms / Q000175:diagnosis; D013166:Spondylitis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D013904:Thoracic Vertebrae / Q000382:microbiology / Q000473:pathology; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000175:diagnosis
D000900:Anti-Bacterial Agents