ABSTRACT

To present and discuss some of the difficulties in the diagnosis of brucellar spondylitis.

We report a patient with lower back pain and pain in both hips, misdiagnosed with a delayed infection after spinal instrumentation, who actually suffered from brucellar spondylitis. Diagnosis was established by analysis of the history and a compatible clinical picture, together with a standard tube agglutination titer of ≥1/160 of antibodies for brucellosis. The patient was treated with a combination of oral doxycycline and ciprofloxacin.

An early diagnosis of brucellar spondylitis can often be difficult. In endemic regions, as in Turkey, brucellar spondylitis should always be considered in the differential diagnosis of older patients with back pain and constitutional symptoms. An early diagnosis will help to prevent the development of more severe complications such as spinal cord compression.