Brucella infection of the thoracic vertebral arch presenting with an epidural abscess: a case report

Although Brucella spondylitis and Brucella discitis have been frequently reported, Brucella infection of the vertebral arch is rare and has not been previously described. We present the first case of Brucella infection of the thoracic vertebral arch with epidural abscess formation and discuss the cl...

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Bibliographic Details
Published in:Journal of medical case reports 2015-10, Vol.9 (1), p.237-237, Article 237
Main Authors: Yin, ZhiXun, He, ErXing, Ding, HongMei, Chen, JingChen
Format: Article
Language:English
Subjects:
Abscess
Anti-Bacterial Agents - therapeutic use
Backache
Blood
Brucella melitensis
Brucellosis - diagnosis
Brucellosis - drug therapy
Care and treatment
Case Report
Case studies
Complications and side effects
Development and progression
Discitis - microbiology
Disease
Doxycycline - therapeutic use
Epidural Abscess - complications
Epidural Abscess - therapy
Health aspects
Humans
Laminectomy
Magnetic Resonance Imaging
Male
Medical examination
Medical treatment
Middle Aged
Rifampin
Rifampin - therapeutic use
Thoracic Vertebrae - diagnostic imaging
Thoracic Vertebrae - surgery
Tomography, X-Ray Computed
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Summary:Although Brucella spondylitis and Brucella discitis have been frequently reported, Brucella infection of the vertebral arch is rare and has not been previously described. We present the first case of Brucella infection of the thoracic vertebral arch with epidural abscess formation and discuss the clinical key points. A 57-year-old man of Han nationality with a history of contact with an isolated sheep stomach 2 months previously was admitted with an undulant fever, night sweats, back pain, and weakness. Thoracic magnetic resonance imaging showed laminar destruction of T9 and an epidural abscess at the T9 to 10 level with significant cord compression. Diagnosis of Brucella infection of his vertebral arch was confirmed by a positive blood culture with growth of Brucella melitensis. Total laminectomy, abscess cleansing, and percutaneous pedicular screw fixation was performed initially, followed by antibiotic treatment with a combination of doxycycline and rifampin for 4 months. Recovery was confirmed by clinical, magnetic resonance imaging, and blood culture findings. This is an unusual case of Brucella infection of the vertebral arch with epidural abscess formation. Effective antibiotic therapy of a sufficient duration and timely performance of surgical treatment are the key points in management of such cases.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-015-0713-6