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. 2016 Jan 7:2:15030.
doi: 10.1038/scsandc.2015.30. eCollection 2016.

Brucellar spondylodiscitis with rapidly progressive spinal epidural abscess showing cauda equina syndrome

Tan Hu  1 , Ji Wu  1 , Chao Zheng  2 , Di Wu  2
Affiliations

Brucellar spondylodiscitis with rapidly progressive spinal epidural abscess showing cauda equina syndrome

Tan Hu et al. Spinal Cord Ser Cases. .

Erratum in

Abstract

Early diagnosis of Brucellosis is often difficult in the patient with only single non-specific symptom because of its rarity. We report a patient with Brucellar spondylodiscitis, in which the low back pain was the only symptom and the magnetic resonance imaging (MRI) showed not radiographic features about infection at initial stage. He was misdiagnosed as a lumbar disc herniation for inappropriate treatment in a long time. The delay in diagnosis and correct treatment led to rapid progression of the disease and severe complications. The patient was treated successfully with triple-antibiotic and surgical intervention in the end. Brucellar spondylodiscitis should always be suspended in the differential diagnosis specially when the patient comes from an endemic area or has consumed dairy products from animals in such an area and comprehensive examination should be done for the patent to rule out some important diseases like Brucellosis with sufficient reasons.

Keywords: Bacterial infection; Bone.

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Figures

Figure 1
Figure 1
CT axial scan showed periosteal proliferation at the edge of L4 vertebral body and bone destruction with osteophytic formation at the L5 vertebral body.
Figure 2
Figure 2
Sagittal T2-weighted MR image revealing areas of hyperintensity in L5 vertebrae, indicating active infectious spondylodiscitis and cartilage endplate involvement. Spinal cord showing normal signal intensity.
Figure 3
Figure 3
MRI demonstrated L4–5 spondylodiscitis and epidural abscesses extending to prevertebral region and epidural space causing cauda equina compression. The T1-weighted images of epidural abscesses were hypointense signals, and the signals in these areas became hyperintense on T2-weighted sequences.
Figure 4
Figure 4
MRI (axial view) showing cauda equina compression resulting from epidural abscess.
Figure 5
Figure 5
Postoperative lateral and AP X-ray showing transpedicular screw fixation on the L4 and L5 vertebral body and the spacer and fixation devices in the correct position.
See this image and copyright information in PMC

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