Eur Spine J, 2007 · DOI: 10.1007/s00586-006-0252-3 · Published: November 14, 2006
Brucellosis is an infection caused by bacteria of the genus Brucella, commonly transmitted through consumption of raw milk products from infected animals. When brucellosis affects the nervous system, it's called neurobrucellosis, potentially leading to meningitis, myelopathy, or cranial neuropathy. This paper presents a unique case of intramedullary brucellar granuloma (IBG) in the cervical spine. The patient, a 35-year-old female, presented with headache, pain, and weakness in her extremities. The patient was treated with a combination of doxycycline, trimethoprim/sulfamethoxazole, and rifampicin for 6 months, resulting in both clinical and radiological recovery. This suggests medical treatment can be effective for such cases.
Clinicians in brucellosis-endemic regions should consider cervical intramedullary brucellar granuloma in the differential diagnosis of intraspinal masses.
A trial of medical treatment with appropriate antibiotics for an extended period (e.g., 9 months) may be considered before surgical intervention, even in cases with significant neurological deficits.
MRI is essential for diagnosing and monitoring granuloma formation in patients with suspected spinal brucellosis to prevent cord compression.