Metagenomic Next-Generation Sequencing in Brucellar Spondylitis with Discordant Serologic Findings in a Non-Endemic Region: A Case Report and Literature Review

Background

Brucellar spondylitis (BS) is a focal osteoarticular manifestation of brucellosis with nonspecific clinical and imaging features. Diagnosis may be difficult in areas where brucellosis is not traditionally considered endemic, particularly when epidemiologic exposure is not identified and serologic tests yield discordant results. We report a case in which metagenomic next-generation sequencing (mNGS) of vertebral lesion tissue provided additional microbiologic evidence for the diagnosis.