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Brucellosis presenting as a spinal epidural abscess in a 41-year-old farmer: a case report

机译：布鲁氏菌病在一名41岁农民中表现为脊髓硬膜外脓肿：病例报告

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Introduction Brucellar epidural abscess is rare but potentially fatal medical entity and very few cases have been reported so far. Whilst in developed countries, cases of brucellar spondylitis and epidural abscess are unusual, since brucellosis has practically been eradicated in animals, in Greece it is one of the most frequent zoonosis. By reporting this case report we want to stress out the importance of early diagnosis and management and also that physicians should keep an open mind and high index of suspicion especially in regions where brucellosis is endemic or when their patients have traveled to these areas and have consumed unpasteurized dairy products. Case presentation We present the case of a 41-year-old male Caucasian farmer complaining of acute, progressively worsening low back pain of five days duration. Fever with rigors, malaise and profuse night sweating were added to the symptoms, two days before admission. Magnetic Resonance imaging clearly showed the lesion and blood and tissue cultures were positive for Brucella melitensis. Conclusion Spinal epidural abscess is a rare condition, difficult to diagnose, may be complicated by potentially disastrous neurological or vascular complications, and it can be fatal if left untreated. Patients complaining of fever and back pain, particularly in endemic areas should be investigated as possible cases of brucellosis and MRI is the method of first choice in the diagnostic process. Neurological dysfunction is often disproportionate to the observed degree of compression. A delay in diagnosis or surgical treatment may result in deleterious sequelae such as permanent paralysis or even death for patients with spinal epidural abscess.
机译：引言布鲁氏膜硬膜外脓肿很少见，但可能致命的医学实体，迄今为止报道的病例很少。在发达国家，布氏杆菌性脊柱炎和硬膜外脓肿并不常见，因为布氏杆菌病已在动物中被根除，在希腊它是最常见的人畜共患病之一。通过报告此病例报告，我们想强调早期诊断和治疗的重要性，并且医生还应保持开放的心态和高度怀疑的态度，尤其是在布鲁氏菌病流行地区或患者前往这些地区并进食时未经巴氏消毒的乳制品。案例介绍我们介绍了一个41岁的男性白种人农民的案例，该农民抱怨持续5天的急性，逐渐加重的下背部疼痛。入院前两天，症状变得更加严格，发烧，全身乏力和大量夜间盗汗。磁共振成像清楚地表明病灶，血液和组织培养物对布鲁氏布鲁氏菌呈阳性。结论脊髓硬膜外脓肿是一种罕见病，难以诊断，可能伴有潜在的灾难性神经或血管并发症，如果不及时治疗可能致命。对于可能发烧和布鲁氏菌病的病例，应调查抱怨发烧和腰痛（尤其是在流行地区）的患者，MRI是诊断过程中的首选方法。神经功能障碍通常与所观察到的压迫程度不成比例。延误诊断或手术治疗可能会导致有害的后遗症，例如永久性麻痹，甚至会导致脊髓硬膜外脓肿死亡。

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