Brucellar Spondylodiscitis 20 Years Post Infection

Human brucellosis remains a neglected zoonosis with global distribution and diverse clinical manifestations. This report describes a case of brucellar spondylodiscitis in a 35-year-old female patient from Syria, residing in Brazil for seven years, with a history of brucellosis diagnosed and treated two decades earlier. The patient presented with chronic back pain, headache, and left upper limb discomfort, with no fever or weight loss. Magnetic resonance imaging revealed a pathological fracture of the T8 vertebral body. Histopathological examination showed a chronic granulomatous inflammatory process with fibrosis and focal necrosis, first treated as bone tuberculosis. After laboratory confirmation of brucellosis, the patient was treated with amikacin, rifampicin, and doxycycline for nine months, showing clinical, radiological, and laboratory improvement. This case highlights the importance of considering brucellosis as a differential diagnosis for spondylodiscitis, even many years after initial infection, especially in patients with relevant epidemiological history.