Brucella Spondylodiscitis: A Case Report of Pediatric Spinal Brucellosis in a 2 year Old Child

Abstract

Brucella spodylodiscitis is one of the most commonly encountered localised form of human brucellosis and the major cause of debilitating and disabling complication. Most commonly, lumbar vertebrae are involved. A 2-year-old child presented with low backache associated with difficulty in walking of 2 months duration. She showed gibbus deformity and tenderness at the level of L2-L3 vertebrae. CBNAAT test  for tuberculosis was negative. MRI spine revealed  diffuse marrow edema of L2-L3 vertebral bodies with reduced L2-L3 disc height. Serological workup showed positive ELISA Brucella antibody IgM titre 1.20. She was treated with IV amikacin for 10 days, oral Rifampicin for 6m and oral Cotrimoxazole for 6 weeks. Repeat imaging after 8 weeks revealed regression of the disease. Followup showed complete clinical and radiological recovery after 6 months. In endemic regions, brucella spondylodiscitis should be considered in patients with back pain with or without neurological deficits. Early and rapid diagnosis and long term antibrucellar antibiotic treatment gives complete recovery.