Brucellar lumbar epidural abscess - Case report and review

Brucellosis is an infectious disease characterized by an acute febrile stage with few or no localizing signs and a chronic stage with relapses of fever, weakness, sweats, and vague symptoms. Brucellosis is one of the major causes of spondylitis in the Mediterranean area. We present a 46-year-old woman who had pain in the low back and both legs for 2 months. The diagnosis was performed on clinical presentation, laboratory findings (Rose Bengal and Wright agglutination tests), and magnetic resonance imaging. Magnetic resonance imaging revealed an extradural mass compressing the thecal sac at the L5-S1 level. The mass was isointense to hypointense compared with the spinal cord on T1WI and heterogenic hyperintense on T2WI. With contrast material, heterogeneous enhancement was seen. The patient was treated with surgery and 3 antibiotics. In an endemic area, brucellosis should be included in the differential diagnosis of any patient complaining of back or leg pain.