title: Collapsed L4 vertebral body caused by brucellosis.
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.
authors.affiliation: Department of Neurosurgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Ekici
authors.affiliation: Department of Neurosurgery, Yunus Emre State Hospital, Eskişehir, Turkey.
authors.forename: Zühtü
authors.initials: Z
authors.lastname: Ozbek
authors.affiliation: Department of Neurosurgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Kazancı
authors.affiliation: Department of Neurosurgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Güçlü
keywords: Brucellosis; Spinal infections; Treatment; Vertebral collapse