Journal Article · 2021
Lumbar and sacral brucellosis due to queso fresco ingestion.
Cassandra Krause, Michael Chang, Jennifer Veltman, Xian Luo-Owen, Esther Kim, Olumide Danisa, Ahmed M Abou-Zamzam, Kaushik Mukherjee
Publication record
Journal of surgical case reports
Krause C, Chang M, Veltman J, Luo-Owen X, Kim E, Danisa O, Abou-Zamzam AM, Mukherjee K Lumbar and sacral brucellosis due to queso fresco ingestion. Journal of surgical case reports. 2021;2021(2):rjaa577. doi:10.1093/jscr/rjaa577. Abstract reproduced from https://pmc.ncbi.nlm.nih.gov/articles/PMC7884021/. License: http://creativecommons.org/licenses/by-nc/4.0/.
Abstract
Abstract Brucellosis is rare in the USA, with 100–200 cases reported annually. In this case we illustrate the complex management of spinal brucellosis. A 22-year-old male presented with 3 months of low back pain. Imaging revealed osteomyelitis/diskitis of L5/S1 and abscesses involving the pre-vertebral, epidural and pelvic recesses. Initial biopsies were inconclusive, but the patient later endorsed eating unpasteurized cheese (queso fresco) from Mexico; therefore, Brucella serology was sent and was positive. Despite aggressive antibiotic therapy there was disease progression. The patient underwent debridement of the involved vertebrae and drainage. Multiple cultures failed to grow the organisms, but Brucella polymerase chain reaction was positive. A month later he underwent a second vertebral debridement as well as placement of tobramycin impregnated beads in the vertebral space. He has since recovered. Surgery should be considered if there is a poor response to medical management and patients may need repeated debridement.