title: Cervical spinal brucellosis with epidural abscess causing neurologic deficit with negative serologic tests.
abstract: BACKGROUND
  Here we present a case of cervical spinal epidural abscess causing neurologic deficits despite negative serologic tests.
  
  
  METHODS
  Unlike a previously reported case, blood cultures and serologic tests were negative for this 50-year-old male with cervical brucellar spondylodiscitis and neurologic deficits. The diagnosis was made based on magnetic resonance imaging (MRI) findings and tissue culture. We drained the epidural abscess, performed anterior cervical discectomy fusion with an iliac strut bone graft, and administered antimicrobial therapy (gentamicin and doxycycline). At the 1-year follow-up visit, a C-spine lateral plain radiograph revealed solid fusion achieved by autogenous strut bone grafting at C4-C5 and C5-C6, and a T2-weighted image showed that epidural abscess and granulation tissue causing spinal cord compression were absent. In addition, the patient had recovered from all of the neurologic deficits with the exception of voiding difficulty.
  
  
  CONCLUSIONS
  It is important for clinicians to consider brucellar cervical spondylodiscitis when an epidural abscess is identified in a patient with a history of potential exposure. We recommend both blood and tissue cultures for diagnosis when serologic tests are negative.
authors.affiliation: Department of Orthopedic Surgery, Chonbuk National University Medical School, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Jeonju, Korea.
authors.forename: Kyung-Jin
authors.initials: KJ
authors.lastname: Song
authors.forename: Sun Jung
authors.initials: SJ
authors.lastname: Yoon
authors.forename: Kwang-Bok
authors.initials: KB
authors.lastname: Lee
mesh_terms: D000818:Animals; D002006:Brucellosis / Q000150:complications* / Q000175:diagnosis / Q000635:transmission; D002417:Cattle; D020802:Epidural Abscess / Q000382:microbiology* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013117:Spinal Cord Compression / Q000382:microbiology* / Q000473:pathology* / Q000601:surgery