Cervical spine Brucellosis presenting as fever with neck stiffness and cervical compressive myelopathy: A case report

Byline: Anita. Basavaraj, Rahul. Kulkarni

Sir,

Osteoarticular brucellosis is the most common presentation of systemic brucellosis and most commonly affects lumbar spine, but isolated involvement of cervical region is very rare, 1.2-2.1%. [sup][1] Cervical spine involvement can pose diagnostic difficulties due to its similarities with other conditions such as tuberculous spondylitis, metastases, and myeloma, [sup][2] causing delay in diagnosis and treatment.

A 60-year-old male farmer presented with moderate-grade intermittent fever and restricted neck movements of one month and 9 days duration, respectively. There was no history of chronic cough, hemoptysis, altered sensorium, neck trauma, weight loss, or any medical illness. General examination was normal except for pallor. Neck stiffness and neck muscle spasm was present. Neurological examination was normal. Blood investigations revealed normocytic normochromic anemia, elevated erythrocyte sedimentation rate of 70 mm at 1 hour, and hyperglobulinemia (globulins - 7.2 gm%). Cerebrospinal fluid examination was normal...