The Spine Journal 15 (2015) 1689–1690
A rare case of longitudinal Brucella myelitis A 48-year-old man, who had subsisted on animal husbandry and consumed unpasteurized milk for many years, presented with lower extremity paraparesis, urinary retention, and hypoesthesia below T7 for 2 months. Spinal magnetic resonance imaging revealed edematous, homogenously T2hyperintense, minimally enhancing lesion extending between C4 and T12 (Figure). Cranial magnetic resonance imaging was unremarkable. Cerebrospinal fluid analysis showed markedly elevated protein (184 mg/dL), hypoglycorachia (40 mg/dL), and pleocytosis (210/mm3). An extensive search for an underlying vasculitic or demyelinating disease did not yield any positive finding. Anti-aquaporin-4 antibody was negative. Diagnosis of a longitudinal Brucella myelitis was made based on the positive cerebrospinal fluid Brucella agglutination test. Rifampycin, doxycyline, and ceftriaxone therapy for 6 months and additionally 5-day pulse steroid treatments were applied. Moderate improvement was
http://dx.doi.org/10.1016/j.spinee.2015.03.002 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
achieved. He was able to walk 50 m with unilateral assistance in the first year of follow-up. Halil Onder, MDa Rahsan Gocmen, MDb Ahmet Cagkan Inkaya, MDc Cagri Mesut Temucin, MDa a Department of Neurology Hacettepe University Hospital 06100 Sıhhıye, Ankara, Turkey b Department of Radiology Hacettepe University Hospital 06100 Sıhhıye, Ankara, Turkey c Department of Infectious Diseases Hacettepe University Hospital 06100 Sıhhıye, Ankara, Turkey FDA device/drug status: Approved (Ceftriaxone, Rifampycin, Doxycyline). Author disclosures: HO: Nothing to disclose. RG: Nothing to disclose. ACI: Nothing to disclose. CMT: Nothing to disclose.
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H. Onder et al. / The Spine Journal 15 (2015) 1689–1690
Figure. Magnetic resonance imaging of the patient.
A rare case of longitudinal Brucella myelitis A 48-year-old man, who had subsisted on animal husbandry and consumed unpasteurized milk for many years, presented with lower extremity paraparesis, urinary retention, and hypoesthesia below T7 for 2 months. Spinal magnetic resonance imaging revealed edematous, homogenously T2hyperintense, minimally enhancing lesion extending between C4 and T12 (Figure). Cranial magnetic resonance imaging was unremarkable. Cerebrospinal fluid analysis showed markedly elevated protein (184 mg/dL), hypoglycorachia (40 mg/dL), and pleocytosis (210/mm3). An extensive search for an underlying vasculitic or demyelinating disease did not yield any positive finding. Anti-aquaporin-4 antibody was negative. Diagnosis of a longitudinal Brucella myelitis was made based on the positive cerebrospinal fluid Brucella agglutination test. Rifampycin, doxycyline, and ceftriaxone therapy for 6 months and additionally 5-day pulse steroid treatments were applied. Moderate improvement was
http://dx.doi.org/10.1016/j.spinee.2015.03.002 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
achieved. He was able to walk 50 m with unilateral assistance in the first year of follow-up. Halil Onder, MDa Rahsan Gocmen, MDb Ahmet Cagkan Inkaya, MDc Cagri Mesut Temucin, MDa a Department of Neurology Hacettepe University Hospital 06100 Sıhhıye, Ankara, Turkey b Department of Radiology Hacettepe University Hospital 06100 Sıhhıye, Ankara, Turkey c Department of Infectious Diseases Hacettepe University Hospital 06100 Sıhhıye, Ankara, Turkey FDA device/drug status: Approved (Ceftriaxone, Rifampycin, Doxycyline). Author disclosures: HO: Nothing to disclose. RG: Nothing to disclose. ACI: Nothing to disclose. CMT: Nothing to disclose.
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H. Onder et al. / The Spine Journal 15 (2015) 1689–1690
Figure. Magnetic resonance imaging of the patient.
