Adult Infectious Diseases Fellowship

Practice session

A 43-year-old man from Najran, Saudi Arabia, presents with 4 weeks of undulant fevers, profuse nocturnal sweats, arthralgias, and severe lower back pain radiating to the buttocks. He reports regular consumption of unboiled camel milk. Physical examination reveals tenderness over the L4-L5 lumbar spine and sacroiliac joint. Standard agglutination tube test (SAT) reveals a Brucella antibody titer of 1:640. Spine MRI confirms L4-L5 spondylodiscitis with epidural phlegmon. What is the evidence-based antimicrobial regimen and duration for complicated brucellosis with spondylodiscitis?

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