Flare Up of Brucella Infection with Formation of Epidural Abscess After Lumbar Fusion; Report of Two Cases

Brucellar spinal infection remains a common health problem in the Middle East. Brucella infection may be difficult to diagnose due to non specific symptoms and signs, this may lead to perioperative complications after spinal surgery. We report two cases of spinal epidural abscess after posterior lumbar decompression and fusion. They were a 35-year male patient and a 48-year female patient underwent posterior lumbar decompression and fusion for multiple degenerative disc herniations. One month after surgery and after sound wound healing both patients complained of low back pain with noticeable swelling at the surgical site without neurological deficit. MRI of the lumbar spine revealed lumbar epidural abscess. Wound exploration with abscess drainage revealed no foreign body with characteristic discharge. Brucellin test was positive for both patient and received anti-brucellar drugs for 3 months. Both patients had a smooth postoperative course after drainage of the abscess and application of antimicrobial therapy.