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 a non-dairy product.
Complete blood count, biochemistry, coagulation tests and conventional radiology were normal.
Blood cultures in conventional media and Ruiz Castañeda were negative.
The serological study for Brucella resulted: Rose Bengala: positive, sero-agglutination: positive (1/20) and anti-brucela-coombs: positive.
Treatment was initiated with Rifampicin 900 mgr/day plus ribavirin 100mgr/12h for 6 weeks.
Five months later she relapsed and had back pain and fever.
On examination, the left iliac region is packed together with a positive psoas sign.
A computerized axial tomography (CAT) showed a L5-S1 spondylodiscitis with involvement of surrounding soft tissues and small bilateral psoas abscess.
It was decided to resume antibiotic treatment prior to which ciprofloxacin 400mgr/12h was added.
A month later, due to the poor response to treatment, percutaneous drainage of psoas was performed.
Because of the poor evolution of the patient, a new CT scan was performed, which showed the existence of bilateral psoas abscesses of large size and involvement of surrounding tissue together with spondylo-diosis.
The patient was admitted to our service where he was operated by the urology and neurosurgery service together performing a drainage of both muscles and the L5-S1 discectomy.
The post-operative period was uneventful and the patient was discharged with antibiotic treatment of oxyhemoglobin 100mgr/12hours along with strong septrim 1/12hours for four months.
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The patient is asymptomatic with good general condition until the last revision three years after surgery.
