Isolation of Brucella melitensis from Lumbar Vertebrae in Patient with Initial Misdiagnosis: A Rare Case with Spinal Epidural Abscess, Spinal Stenosis, and Brain Lesion

Introduction: Brucellar spondylodiscitis is among the most typical forms of osteoarticular involvement that still challenges clinicians and scientists for early diagnosis. Case Presentation: We describe isolation Brucella melitensis from vertebrae in a man with who had osteoarthritis as an underlying condition. The patient showed negative results on blood samples' serological, molecular, culture tests low-back pain, restricted lumbar movements, headache, poor appetite, fatigue past nine months. He history regular ingestion raw cow milk products long time. First, he was misdiagnosed disc herniation then underwent nonsteroidal anti-inflammatory drugs myorelaxants treatment. lack fast diagnosis appropriate treatment led to severe complications disease. Three months after first magnetic resonance imaging (MRI), findings second MRI without intravenous contrast right lateral recess canal stenosis at L4 - L5 narrowing thecal sac space. Abnormal enhancement endplates relating epidural space-enhancing tissue setting associated abscess seen behind L4. Moreover, extensive high signal abnormalities paraspinal tissues L3, L4, L5, S1, S2, S3 were notable. approved by isolating B. biovar 1 vertebrate body. isolate characterized Bruce-ladder PCR, AMOS classical biotyping. treated successfully surgical intervention triple-antibiotic, including oral doxycycline 100 mg/12 h plus rifampin 300 three intramuscular streptomycin g daily two weeks. patient’s general condition pain remarkably improved follow-up. Conclusions: Patient histories series different diagnostic procedures such MRI, serology, cultural are essential make rapid accurate brucellar spondylodiscitis, thereby reducing delay