Spinal epidural abscess caused by Brucella species: a review of 17 cases

BACKGROUND: Spinal epidural abscess (SEA) is a rarely encountered clinical entity during the course of Brucella infection. METHODS: We reported 17 patients diagnosed with Brucellar SEA for a mean follow-up of 15 months. Spinal epidural abscess was detected by magnetic resonance imaging in all cases. Brucella diagnosis was established by serological tests. Patients were administered antibiotics for duration of 6 to 16 weeks. RESULTS: SEA was localized in lumbar region in 9 patients, thoracic in 4 patients, cervical in 3 patients, both thoracic and lumbar in 1 patient. Neurologic examination was normal in 4 patients, we detected motor and/or sensory deficit in 13 patients. Symptoms regressed in all patients after the institution of antibiotic regimens, and all recovered fully. Surgical drainage of abscess was performed in 2 patients and 3 patients were performed limited laminectomies. CONCLUSION: Antibiotic therapy could be primary treatment and is effective in required doses and duration for many patients. If neurologic deterioration be observed despite proper antibiotic regimens in required doses and duration, surgical intervention is to be performed.