All spinal infections are not always tuberculosis: A rare case of brucella spondylodiscitis in South India.

A 49-year-old male presented with persistent fever for 20 days, accompanied by chills, headache, and vomiting. Medical history included congenital hearing impairment and speech difficulty, limiting communication; hence, the history was obtained from his wife. On examination, he was irritable, alert, and had neck stiffness without motor or sensory deficits. Cervical spine tenderness prompted a magnetic resonance imaging of the cervical spine, which demonstrated infective spondylodiscitis involving C6-C7. Given the endemic setting, multiple contiguous vertebral involvement, and occupational exposure as a butcher handling unvaccinated goats, differential diagnoses included tuberculous spondylitis and brucellosis. Blood cultures were performed from two sites; the second sample grew Brucella melitensis, identified using the VITEK 2 Compact system after incubation in the BACT/ALERT 3D system and subculture on blood agar. Treatment consisted of gentamicin, doxycycline, and rifampin. The patient became afebrile within 48 h and remained stable. He was discharged with instructions to complete the oral regimen, consisting of doxycycline and rifampin, and to wear a hard cervical collar.