Priya Padma, Solomon Prince, Nair Shashikala, Mohankumar Poornachandran
Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry, India.
Department of Microbiology, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry, India.
J Orthop Case Rep. 2022 Sep;12(9):10-14. doi: 10.13107/jocr.2022.v12.i09.2994.
Infective spondylodiscitis refers to simultaneous inflammation of vertebrae and disc and usually occurs through hematogenous spread. The most common presentation of brucellosis is febrile illness, but it can rarely present as spondylodiscitis. Rarely, human cases of brucellosis are diagnosed and treated clinically. We describe a case of previously healthy man in his early 70s who presented with symptoms suggestive of spinal tuberculosis, then diagnosed to have brucellarspondylodiscitis.
A 72-year-old farmer presented to our orthopedic department with a history of chronic lower back pain. Spinal tuberculosis was suspected at a medical facilitynear his residence, based on magnetic resonance imaging consistent with infective spondylodiscitis, and the patient was referred to our hospital for further management. Investigations revealed that the patient had an uncommon diagnosis of Brucellar spondylodiscitis for which he was managed accordingly.
Brucellar spondylodiscitis may clinically mimic spinal tuberculosis; hence, it must be considered as a differential diagnosis in a patient presenting with the lower back pain (particularly in the elderly) and signs of a chronic infection. Screening serological testing is vital in early identification and management of spinal brucellosis.
感染性脊椎椎间盘炎是指椎体和椎间盘同时发生炎症，通常通过血行播散。布鲁氏菌病最常见的表现是发热性疾病，但很少表现为脊椎椎间盘炎。临床上很少诊断和治疗人类布鲁氏菌病病例。我们描述了一例70岁出头的既往健康男性，他最初表现出提示脊柱结核的症状，随后被诊断为布鲁氏菌性脊椎椎间盘炎。
一名72岁的农民因慢性下背痛病史就诊于我院骨科。根据与感染性脊椎椎间盘炎相符的磁共振成像，其居住地附近的医疗机构怀疑为脊柱结核，该患者被转诊至我院进一步治疗。检查发现该患者患有罕见的布鲁氏菌性脊椎椎间盘炎，并据此进行了相应治疗。
布鲁氏菌性脊椎椎间盘炎在临床上可能与脊柱结核相似；因此，对于出现下背痛（尤其是老年人）和慢性感染体征的患者，必须将其视为鉴别诊断之一。筛查血清学检测对于早期识别和治疗脊柱布鲁氏菌病至关重要。
