{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T05:53:49Z","timestamp":1777182829658,"version":"3.51.4"},"reference-count":28,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,11,5]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>We report a case of infectious spondylitis in a 52-year-old woman who presented with progressive difficulty in walking. The patient had a 2-month long history of neurological symptoms, which progressed rapidly to paraplegia, following her admission. Imaging studies demonstrated the presence of vertebral lesions as well as additional tissue with inflammatory elements in the spinal canal, which caused a mass effect. In combination with the presence of increased cells and protein in the cerebrospinal fluid (CSF), the differential was steered towards causes of infectious spondylitis, primarily tuberculosis. However, brucellosis was also considered, as it is endemic in our area. Prompt surgical decompression produced biopsy samples, which confirmed the presence of granulomatous inflammation. The patient was started on an empiric regimen covering both for tuberculosis and brucellosis, and gradually regained full mobility in her lower limbs. The differential of infectious spondylitis is discussed, with an emphasis on the differentiation between tuberculosis and brucellosis.<\/jats:p>","DOI":"10.1136\/bcr-2019-232540","type":"journal-article","created":{"date-parts":[[2019,11,25]],"date-time":"2019-11-25T04:25:19Z","timestamp":1574655919000},"page":"e232540","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Granulomatous infective spondylitis in a patient presenting with progressive difficulty in walking: the differential between tuberculosis and brucellosis"],"prefix":"10.1136","volume":"12","author":[{"given":"Eleni","family":"Papachristodoulou","sequence":"first","affiliation":[{"name":"Respiratory Medicine, University of Patras School of Medicine, Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6245-1569","authenticated-orcid":false,"given":"Loukas","family":"Kakoullis","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, University of Patras School of Medicine, Patras, Greece"},{"name":"Internal Medicine, Nicosia General Hospital, Leukosia, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stylianos","family":"Louppides","sequence":"additional","affiliation":[{"name":"Internal Medicine, Nicosia General Hospital, Leukosia, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2712-5909","authenticated-orcid":false,"given":"George","family":"Panos","sequence":"additional","affiliation":[{"name":"Internal Medicine, Section of Infectious Diseases, University General Hospital of Patras, Patras, Greece"},{"name":"Internal Medicine, University Cyprus School of Medicine, Nicosia, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,11,24]]},"reference":[{"key":"2025082703523175000_12.11.e232540.1","first-page":"106","article-title":"Pott's spine and paraplegia","volume":"44","author":"Gautam","year":"2005","journal-title":"JNMA J Nepal Med Assoc"},{"key":"2025082703523175000_12.11.e232540.2","doi-asserted-by":"crossref","first-page":"e1017","DOI":"10.3928\/01477447-20171012-03","article-title":"Features of 921 patients with spinal tuberculosis: a 16-year investigation of a general Hospital in Southwest China","volume":"40","author":"Yao","year":"2017","journal-title":"Orthopedics"},{"key":"2025082703523175000_12.11.e232540.3","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldw003"},{"key":"2025082703523175000_12.11.e232540.4","doi-asserted-by":"publisher","DOI":"10.1179\/2045772311Y.0000000023"},{"key":"2025082703523175000_12.11.e232540.5","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq303"},{"key":"2025082703523175000_12.11.e232540.6","first-page":"127","article-title":"Tuberculous spondylitis--analysis of 22 cases","volume":"109","author":"Kostov","year":"2009","journal-title":"Acta Neurol Belg"},{"key":"2025082703523175000_12.11.e232540.7","first-page":"200","article-title":"[Variety of ESR and C-reactive protein levels during perioperative period in spinal tuberculosis]","volume":"23","author":"Guo","year":"2010","journal-title":"Zhongguo Gu Shang"},{"key":"2025082703523175000_12.11.e232540.8","first-page":"1","article-title":"The evaluation of the clinical, laboratory, and radiological findings of 16 cases of brucellar spondylitis","volume":"2016","author":"Yang","year":"2016","journal-title":"Biomed Res Int"},{"key":"2025082703523175000_12.11.e232540.9","doi-asserted-by":"publisher","DOI":"10.1086\/313524"},{"key":"2025082703523175000_12.11.e232540.10","doi-asserted-by":"crossref","unstructured":"Singh B , Cocker D , Ryan H , et al . 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