11/37. Brucella spondylitis with paravertebral abscess due to brucella melitensis infection: a case report.This report describes the case of a 45-year-old woman with a 5-month history of fever, generalized malaise, myalgia, lower back pain and difficulty in walking. Serodiagnosis for brucella, carried out at the onset of symptoms 5 months previously, was negative. When the patient was admitted to our hospital there was contracture of the paraspinal muscles but no peripheral nerve damage. Laboratory tests showed positive agglutination for Brucella and an increase in the rate of dilution from 1/160 to 1/640 over 2 weeks. Radiographs and a computed tomography scan of the spine revealed bone erosion in the posterior borders of the L4-L5 vertebral end plates and a soft tissue mass surrounding the interposed disc and protruding into the spinal canal. magnetic resonance imaging confirmed the presence of a paraspinal abscess around the affected disc and tissue edema. culture tests of the blood and abscess tissue, taken by biopsy, were negative. Rifampicin treatment (600 mg daily), combined with a bust cast to immobilize the spine, led to clinical healing without the need for surgery. Because onset symptoms are nonspecific and insidious, in nonrisk subjects a diagnosis of brucellosis may sometimes be suspected only if there are local symptoms. The phenomenon of the absence of positivity in patients with a high antibody titer should also be considered Cases such as that described herein demonstrate the need for culture tests and serodiagnosis, even in nonrisk patients with persistent fever and arthralgia, to prevent the later complications of brucellosis.- - - - - - - - - - ranking = 1keywords = back pain, back (Clic here for more details about this article) |
12/37. bone marrow hypoplasia during Brucella infection.pancytopenia, although mainly reported in adults, has also been described in children with brucellosis. However, bone marrow hypoplasia is a rare feature of the infection. An 11-year-old boy was admitted with fever, vomiting, and abdominal pain of 10 days' duration. On physical examination, pallor and high fever were detected in the absence of lymphadenopathy and hepatosplenomegaly. His hemoglobin was 8.6 g/dL, white blood cell count 1,100/mm(3), neutrophil count 500/mm(3), platelets 56,000/mm(3), and reticulocytes 0.1%. Hypocellular bone marrow was found by aspiration, and bone marrow biopsy revealed hypocellularity. The agglutination titer was greater than 1/640. trimethoprim/sulfamethoxazole was prescribed. His fever subsided and pancytopenia subsequently improved. pancytopenia associated with brucellosis is attributed to hypersplenism, hemophagocytosis, and granulomatous lesions of the bone marrow, which is usually hypercellular. bone marrow hypoplasia is rarely reported and should be kept in mind in the etiology of aplastic anemia in a country where brucellosis is frequently encountered.- - - - - - - - - - ranking = 0.088510733997421keywords = abdominal pain (Clic here for more details about this article) |
13/37. Abducent nerve palsy during treatment of brucellosis.brucellosis is an infectious disease with multisystem involvement caused by the genus Brucella. Neurological complications including meningitis, meningoencephalitis, myelitis-radiculoneuritis, brain abscess, epidural abscess, and meningovascular syndromes are rarely encountered. We present here a patient with sixth cranial nerve palsy that occurred during treatment for brucellosis, a form of presentation rarely been reported in English-language literature. We conclude that neurobrucellosis, pseudotumor cerebri, and side effects of tetracyclines which are frequently used in brucellosis should be kept in mind when considering intractable headaches and cranial nerve palsies in patients with brucellosis.- - - - - - - - - - ranking = 0.11456165415646keywords = headache (Clic here for more details about this article) |
14/37. Spontaneous bacterial peritonitis due to Brucella infection.Brucella infection is a systemic disease, but the microorganism rarely causes infections in the gastrointestinal system such as hepatitis, cholecystitis, colitis and pancreatitis. Spontaneous bacterial peritonitis due to Brucella is extremely rare. Herein, we report a case of cirrhosis complicated with nongranulomatous hepatitis and peritonitis, both due to Brucella. A 63 year-old man with diabetes mellitus was admitted to hospital with complaints of weakness, backache, abdominal pain and abdominal swelling. On the basis of physical examination and laboratory findings, cryptogenic cirrhosis and spontaneous bacterial peritonitis were diagnosed. Due to persistent fever and backache, serum Brucella agglutination test was performed and found to be positive. brucella melitensis was isolated from ascitic fluid culture. liver biopsy findings revealed cirrhosis and a nongranulomatous hepatitis which was thought might be due to Brucella infection. doxycycline and rifampicin, in addition to diuretics were administered for spontaneous ascites infection due to Brucella. A week later, the patient's condition improved and he became afebrile. After two months of therapy, the ascites had almost disappeared.- - - - - - - - - - ranking = 0.18156530386863keywords = abdominal pain, back (Clic here for more details about this article) |
15/37. A case of metastatic spinal Ewing's sarcoma misdiagnosed as brucellosis and transverse myelitis.An 11-year-old girl was admitted with back pain for 2 months, inability to walk for 15 days, and enuresis and encopresis for 2 days. She had been hospitalized with the diagnosis of brucellosis in another hospital. At presentation, she had paraplegia, sphincter dysfunction, and bilateral sensory loss below the T6 level, and was initially diagnosed with transverse myelitis caused by brucellosis. On the third day of hospitalization, however, agglutination test for brucella was negative, but it was positive for salmonella. Therefore, transverse myelitis was considered to be due to salmonellosis. Thoracic spine magnetic resonance imaging showed an extradural, paraspinal mass at the level of T6-T7. The mass was totally extracted, and histopathological examination revealed Ewing's sarcoma. During follow-up, no improvement in paraplegia was noted and an enlarged presacral decubital ulcer developed. Aside from supportive care, local radiotherapy was applied. Unfortunately, the patient died from probable infection 9 months after the diagnosis. We emphasize that metastatic spinal Ewing's sarcoma may mimic brucellosis and transverse myelitis in childhood.- - - - - - - - - - ranking = 1keywords = back pain, back (Clic here for more details about this article) |
16/37. Brucellar spondylitis: a rare cause of spinal cord compression.STUDY DESIGN: A case report. OBJECTIVES: To present and discuss some of the difficulties in the diagnosis of brucellar spondylitis. SETTING: Ankara University, Ibni Sina Hospital, turkey. methods: We report a patient with paraplegia, misdiagnosed as having a malignancy or tuberculosis who actually suffered from brucellar spondylitis. Diagnosis was established by her history and a compatible clinical picture together with a standard tube agglutination (Wright test) titer of > or =1/160 of antibodies for brucellosis. The patient was treated with oral doxycycline, rifampicin, and ciprofloxacin combination. RESULTS: At the end of the treatment, the blood Brucella Wright and anti-human globulin T titer levels decreased. Her lower limb weakness improved. She could walk, and climb stairs with the help of a cane. urinary retention and fecal incontinence also resolved. CONCLUSION: brucellosis is a systemic infection involving the musculoskeletal and nervous systems. spondylitis frequently occurs in elderly patients. An early diagnosis of brucellar spondylitis can often be difficult. In endemic regions, as in the case of our country, brucellar spondylitis should always be considered in the differential diagnosis of older patients with back pain and constitutional symptoms. An early diagnosis will help to prevent the development of more severe complications such as spinal cord compression.- - - - - - - - - - ranking = 1keywords = back pain, back (Clic here for more details about this article) |
17/37. Lumbar pain in a married couple who likes cheese: brucella strikes again!A 69-year-old man living in Florence reported fever and acute lumbar pain one month after transurethral resection of a superficial transitional cell carcinoma of the bladder. The radionuclide bone scan suggested metastatic lesions of the L3-L4 vertebrae. However cobalt treatment was ineffective. A bone biopsy of L4 showed an inflammatory pattern and antibiotic therapy was started which did not produce any clinical improvement. Six months after the onset of the back pain brucellar spondylitis was serologically diagnosed and treatment with doxycycline and streptomycin produced a significant clinical and radiological improvement. After 2 months the patient's wife presented with fever and lumbar pain, and brucellar spondylitis was diagnosed as well. An extensive epidemiological examination revealed that 8 months earlier the family had eaten unpasteurized goat cheese and serological examination of the entire family showed that 3 out of 4 members had significant titres of brucellar antibodies. Finally it was discovered that 4 months after consuming the cheese the third infected subject experienced an episode of epidydimoorchitis for which no diagnosis and effective treatment was found. This family cluster of brucellar infection indicates that a high degree of suspicion in the diagnosis of brucellosis is necessary even in non-endemic areas, to reduce the delay in the diagnosis and treatment of the disease and to prevent the occurrence of complications that may prove difficult to treat.- - - - - - - - - - ranking = 1keywords = back pain, back (Clic here for more details about this article) |
18/37. Primary brucellar psoas abscess: presentation of a rare case of psoas abscess caused by brucella melitensis without any osteoarticular involvement.The psoas abscess is an entity, sometimes forgotten in our daily practice, because of infrequency and difficulties in diagnosis. Primary psoas abscess is very rare and gram-positive micro-organisms account for more than 80% of the cases. Our case, a 62-year-old man was admitted with a 5-year history of back pain and fever. physical examination was normal, except a palpable hepatomegaly with a mild tenderness over his lower right abdominal quadrant. The Brucella agglutination test was strongly positive with a titre of 1/640, as rose bengal Spot test. Blood cultures for brucella were positive on the fourth day and became negative, as the specific therapy started. Further examination with ultrasonography and computed tomography revealed an abscess of 40 75 mm in the psoas muscle. Complete resolution of symptoms achieved within 6 weeks. Although clinical presentation of psoas abscesses is often similar and non-specific, early aetiological diagnosis is extremely important, because of high achievement with appropriate antibiotic regimens. Brucellar psoas abscess seems very rare even in turkey, where Brucella is still highly endemic. Such a case has not been previously reported from turkey, as far as we know.- - - - - - - - - - ranking = 1keywords = back pain, back (Clic here for more details about this article) |
19/37. Successful medical treatment of intracranial abscess caused by Brucella spp.An unusual presentation of unilateral cerebellar abscesses due to neurobrucellosis observed in a patient is reported. He gave a history of fever, headache, vomiting and had unilateral cerebellar signs. The abscess was detected on magnetic resonance imaging (MRI) and analysis of cerebrospinal fluid revealed neurobrucellosis. Patient treated by only antibiotics therapy, evolving to complete clinical and radiological resolution, without neurosurgical intervention. We are presenting a case of cerebellar abscess due to neurobrucellosis diagnosed by MRI, treated medically, and had both radiologic and clinical follow-up. We also made a review of the literature concerning the cerebellar abscess due to neurobrucellosis.- - - - - - - - - - ranking = 0.11456165415646keywords = headache (Clic here for more details about this article) |
20/37. Lumbosacral spinal epidural abscess caused by brucella melitensis.Spinal epidural abscess is a rare condition that can lead to irreversible complications and death if untreated. Rarely, brucella melitensis may produce spondylodiscitis, which may be complicated by spinal epidural abscess. We report a case of lumbosacral spinal epidural abscess caused by brucella melitensis. Spinal brucellosis should be kept in mind in the differential diagnosis of low back pain.- - - - - - - - - - ranking = 1keywords = back pain, back (Clic here for more details about this article) |
| <- Previous || Next -> |