Abstract

A 77-year-old female patient was admitted to our hospital because of low back pain radiating to the right leg for one month. In her history, her abrupt back pain was started in July 2011 and she had been hospitalized in neurosurgery department and after the magnetic resonance imaging (MRI) of the lumbar region, a lumbar disc herniation (LDH) at the L4-L5 level was observed. Serological tests were also performed and showed high levels of Brucella antigen (1/640). The patient was diagnosed as having Brucella infection and therapy consisting of doxycycline and streptomycin was commenced. After 14 days of this combination therapy, streptomycin was altered with rifampicin. Doxycycline and rifampicin were administered for 3 months. At the end of that therapy the patient was free of pain and his physical and neurological examination was found to be normal. In conclusion, brucellar discitis and spondylitis should also be considered in the differential diagnosis of long standing back pain in suspected cases particularly in regions where brucellosis is endemic.

Key words: Brucella spondylodiscitis, lumbar disc, herniation