We present two patients with acute Thoracolumbar spondylodiscitis that developed one week after consumption of goat milk colostrum.

Patient 1:

An 80-year-old patient presented with lower back pain, bilateral lower extremity weakness, and fever of 38°C one week after consuming goat milk colostrum. Previously independent in daily activities, she became bed-bound with bilateral lower limb weakness. She didn't respond to oral antibiotic treatment. She was subsequently referred to our hospital for further evaluation and management.

Initial labs revealed WBC 7600/uL, CRP of 98 mg/dL, Brucella titer: More than 1:320. Blood Culture grew Brucella organisms.

Spinal MRI (Figure A) showed signal changes in the L2 and L3 vertebral bodies, including the pedicles and intervertebral discs, with destruction of the disc space endplates. Post-contrast imaging reveals enhancement of the affected vertebrae and prevertebral soft tissues without abscess formation consistent with diagnosis of acute lumbar spondylodiscitis.

The patient received Doxycycline 100 mg twice daily and Rifampin 600 mg once daily

Figure A

Patient 2:

A 65-year-old male patient presented with acute mid to lower back pain, high grade fever, night sweats and fatigue two weeks following the consumption of unpasteurized goat milk. Laboratory tests revealed elevated inflammatory markers and serological evidence of Brucella infection, Similar findings were seen in 10 of his family members who also ingested the milk and sought medical attention.

A spinal MRI (Figure B and C) showed hyperintense signal and changes at T12-L1, and L3-L4 levels with paravertebral soft tissue edema indicating discitis and osteomyelitis. Patient and his family were started on Doxycycline and Rifampin therapy for 12 weeks

Figure B

Figure C

These cases highlight the important association between Brucella osteoarticular disease and the consumption of goat milk colostrum. Both patients presented with severe back pain and systemic symptoms following dairy consumption, and subsequent imaging revealed osteoarticular involvement characteristic of Brucella infection. The link to unpasteurized dairy products is significant, as Brucella species are known to be transmitted through such routes. These cases underscore the importance of considering Brucella infection in patients presenting with fever and back pain following the consumption of unpasteurized dairy products.

Conflict of Interest Statement: The authors declare no conflicts of interest.

Source of Funding Statement: No funding was received for this work.