A 42-year-old man, resident in Mérida (Extremadura), with a personal history of type I diabetes mellitus and chronic prostatitis, consulted three weeks after ingestion of an unsanitised dairy product due to fever and general malaise. Complementary tests showed an unaltered haemogram, biochemistry, coagulation tests and conventional radiology. Blood cultures in conventional and Ruiz Castañeda media were negative. The serological study for Brucella was: Rose Bengal: positive, sero-agglutination: positive (1/20) and antibrucella-coombs: positive.
Treatment was started with Rifampicin 900mg/day plus doxacycline 100mg/12h for 6 weeks.
After five months he suffered a relapse and presented with lumbar pain and fever. On examination the left iliac region was impacted together with a positive psoas sign. A computerised axial tomography (CAT) scan showed L5-S1 spondylodiscitis with involvement of the surrounding soft tissues and a small bilateral psoas abscess. It was decided to resume previous antibiotic treatment with the addition of ciprofloxacin 400mgr/12h. After one month, given the poor response to treatment, transcutaneous drainage of the psoas collections was performed.
In view of the poor evolution of the patient, a new CT scan was performed, showing the existence of large bilateral psoas abscesses and involvement of the surrounding tissue together with spondylodiscitis at L5-S1. The patient was referred to our department where he was operated on by the urology and neurosurgery departments together, with drainage of both muscles and L5-S1 discectomy. The postoperative period was uneventful and the patient was discharged with antibiotic treatment with doxycycline 100mgr/12hours together with septrim forte 1/12hours for four months.

The patient is asymptomatic with good general condition until the last check-up three years after surgery.
