Cervical epidural abscess due to Brucella treated with decompression and instrumentation: a case report and review of literature

 

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Brucella is caused by a Gram-negative bacillus and is a common disease in endemic areas where people are in close contact with animals and dairy products, but brucellar cervical epidural abscess is rare. We describe a rare case of a C5–6 brucellar epidural abscess in a veterinary doctor who was treated with decompression and instrumentation. We also review the cases of cervical brucellar epidural abscess treated with instrumentation in the literature.

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Publication History

Received: 11 December 2019

Accepted: 17 March 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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• References

• 1 Madkour MM, Sharif HS, Abed MY, Al-Fayez MA. Osteoarticular brucellosis: Results of bone scintigraphy in 140 patients. AJR Am J Roentgenol 1988;150:1101-5.
• 2 Traxler RM, Lehman MW, Bosserman EA, Guerra MA, Smith TL. A literature review of laboratory-acquired brucellosis. J Clin Microbiol 2013;51:3055-62.
• 3 González-Gay MA, García-Porrúa C, Ibañez D, García-País MJ. Osteoarticular complications of brucellosis in an Atlantic area of Spain. J Rheumatol 1999;26:141-5.
• 4 Khateeb MI, Araj GF, Majeed SA, Lulu AR. Brucella arthritis: A study of 96 cases in Kuwait. Ann Rheum Dis 1990;49:994-8.
• 5 Koubaa M, Maaloul I, Marrakchi C, Lahiani D, Hammami B, Mnif Z, et al. Spinal brucellosis in South of Tunisia: Review of 32 cases. Spine J 2014;14:1538-44.
• 6 Ulu-Kilic A, Karakas A, Erdem H, Turker T, Inal AS, Ak O, et al. Update on treatment options for spinal brucellosis. Clin Microbiol Infect 2014;20:O75-82.
• 7 Darouiche RO. Spinal epidural abscess. N Engl J Med 2006;355:2012-20.
• 8 Todd NV. Letter to the editor concerning Cauda Equina Syndrome treated by surgical decompression: The influence of timing on surgical outcome by A. Qureshi, P. Sell Eur Spine J 2007;16:2143-51.
• 9 Shiban E, Janssen I, da Cunha PR, Rainer J, Stoffel M, Lehmberg J, et al. Safety and efficacy of polyetheretherketone (PEEK) cages in combination with posterior pedicel screw fixation in pyogenic spinal infection. Acta Neurochir (Wien) 2016;158:1851-7.
• 10 Talia AJ, Wong ML, Lau HC, Kaye AH. Safety of instrumentation and fusion at the time of surgical debridement for spinal infection. J Clin Neurosci 2015;22:1111-6.
• 11 Colmenero JD, Jiménez-Mejías ME, Sánchez-Lora FJ, Reguera JM, Palomino-Nicás J, Martos F, et al. Pyogenic, tuberculous, and brucellar vertebral osteomyelitis: A descriptive and comparative study of 219 cases. Ann Rheum Dis 1997;56:709-15.
• 12 Tekkök IH, Berker M, Ozcan OE, Ozgen T, Akalin E. Brucellosis of the spine. Neurosurgery 1993;33:838-44.
• 13 Ariza J, Gudiol F, Valverde J, Pallarés R, Fernández-Viladrich P, Rufí G, et al. Brucellar spondylitis: A detailed analysis based on current findings. Rev Infect Dis 1985;7:656-64.
• 14 Lifeso RM, Harder E, McCorkell SJ. Spinal brucellosis. J Bone Joint Surg Br 1985;67:345-51.
• 15 Colmenero JD, Cisneros JM, Orjuela DL, Pachón J, Garcia-Portales R, Rodriguez-Sampedro F, et al. Clinical course and prognosis of Brucella spondylitis. Infection 1992;20:38-42.
• 16 Ekici MA, Ozbek Z, Gökoǧlu A, Menkü A. Surgical management of cervical spinal epidural abscess caused by Brucella melitensis: Report of two cases and review of the literature. J Korean Neurosurg Soc 2012;51:383-7.
• 17 Ugarriza LF, Porras LF, Lorenzana LM, Rodríguez-Sánchez JA, García-Yagüe LM, Cabezudo JM. Brucellar spinal epidural abscesses. Analysis of eleven cases. Br J Neurosurg 2005;19:235-40.
• 18 Bodur H, Erbay A, Colpan A, Akinci E. Brucellar spondylitis. Rheumatol Int 2004;24:221-6.
• 19 Ates O, Cayli SR, Koçak A, Kutlu R, Onal RE, Tekiner A. Spinal epidural abscess caused by brucellosis. Two case reports. Neurol Med Chir (Tokyo) 2005;45:66-70.
• 20 Hantzidis P, Papadopoulos A, Kalabakos C, Boursinos L, Dimitriou CG. Brucella cervical spondylitis complicated by spinal cord compression: A case report. Cases J 2009;2:6698.
• 21 Lee HJ, Hur JW, Lee JW, Lee SR. Brucellar spondylitis. J Korean Neurosurg Soc 2008;44:277-9.
• 22 Turgut M, Turgut AT, Koşar U. Spinal brucellosis: Turkish experience based on 452 cases published during the last century. Acta Neurochir (Wien) 2006;148:1033-44.
• 23 Kadanali A, Ozden K, Altoparlak U, Erturk A, Parlak M. Bacteremic and nonbacteremic brucellosis: Clinical and laboratory observations. Infection 2009;37:67-9.
• 24 Seidel G, Pardo CA, Newman-Toker D, Olivi A, Eberhart CG. Neurobrucellosis presenting as leukoencephalopathy: The role of cytotoxic T lymphocytes. Arch Pathol Lab Med 2003;127:e374-7.
• 25 Solera J, Lozano E, Martínez-Alfaro E, Espinosa A, Castillejos ML, Abad L. Brucellar spondylitis: Review of 35 cases and literature survey. Clin Infect Dis 1999;29:1440-9.
• 26 Mandell GL, Bennett J, Dolin R, editors. Principles and Practice of Infectious Diseases. Brucella species. Vol. 2. Philadelphia: Churchill Livingstone; 2005.
• 27 Yousefi-Nooraie R, Mortaz-Hejri S, Mehrani M, Sadeghipour P. Antibiotics for treating human brucellosis. Cochrane Database Syst Rev 2012;10:CD007179.
• 28 Salzmann SN, Derman PB, Lampe LP, Kueper J, Pan TJ, Yang J, et al. Cervical spinal fusion: 16-year trends in epidemiology, indications, and in-hospital outcomes by surgical approach. World Neurosurg 2018;113:e280-e295.