Spinal Neurobrucellosis is an Unusual Cause of Nontraumatic Paraplegia in Zaria, Northern Nigeria: A report of 3 Cases and Review of Current Literature

Abstract

Introduction: Brucellosis is a zoonotic febrile infection common among farmers or herdsmen who come into contact with animals or animal products. Neurological complications are uncommon, but when they occur can be confused with other neurological diseases, particularly those due to tuberculosis (TB). Aim: This report is intended to remind health workers and people living in Brucella endemic communities that spinal neurobrucellosis can mimic Potts’ disease as the cause of nontraumatic paraparesis or paraplegia. Study Design: longitudinal case series. Methodology: We report the cases of three patients who presented with paraplegia following months of constitutional symptoms of fever, headache, malaise and weight loss. All were exposed to cows, goats and sheep. One patient had received antituberculous therapy for 18 months with minimal recovery. Serology and neuroimaging were used to confirm the diagnosis. Results: All patients recovered within 6 to 12 weeks of rifampicin, doxycycline, trimethoprim-sulfamethoxazole or streptomycin, but with residual paraparesis. Conclusion: spinal neurobrucellosis can be confused with Pott’s disease (TB of the spine) with consequent poor treatment outcome.