Harman Mustafa, Irmak Hasan, Arslan Halil, Arslan Unal, Kayan Mustafa
Department of Radiology, University of Yüzüncü Yil Faculty of Medicine, Maraş Caddesi, 65200 Van, Turkey.
J Clin Ultrasound. 2004 Jan;32(1):33-6. doi: 10.1002/jcu.10217.
Brucellosis is still a public health problem, particularly in developing countries. After the primary infection subsides, a chronic stage characterized by nonspecific manifestations can develop, during which it may not be possible to isolate Brucella organisms and agglutination test titers may or may not be high. We present the case of a 49-year-old man who had only nonspecific symptoms and a 2-month history of a pulsatile painful swelling in his right popliteal region. He had no history of trauma or surgery in that region, but he did ingest unpasteurized milk products. The patient's agglutination test titers were high, and Brucella melitensis was isolated from a bone marrow culture. Color Doppler sonography, T2-weighted MRI, and digital subtraction angiography were performed. Treatment with ultrasound-guided compression of the pseudoaneurysm failed because of high blood flow in its neck. Aneurysmectomy was undertaken, and the excised material was consistent with that from a mycotic pseudoaneurysm. Although both MRI and angiography provided useful information, the color Doppler sonography findings were characteristic of a pseudoaneurysm in the popliteal artery, and only that modality could detect the flow dynamics within the pseudoaneurysm.
布鲁氏菌病仍然是一个公共卫生问题，在发展中国家尤为如此。初次感染消退后，可能会进入以非特异性表现为特征的慢性阶段，在此期间可能无法分离出布鲁氏菌，凝集试验效价可能高也可能不高。我们报告一例49岁男性病例，该患者仅有非特异性症状，右腘窝区域有搏动性疼痛性肿胀，病史2个月。该区域无创伤或手术史，但他曾食用未杀菌的奶制品。患者凝集试验效价高，骨髓培养分离出羊种布鲁氏菌。进行了彩色多普勒超声、T2加权磁共振成像和数字减影血管造影检查。由于假性动脉瘤颈部血流速度快，超声引导下对假性动脉瘤进行压迫治疗失败。实施了动脉瘤切除术，切除的组织与真菌性假性动脉瘤相符。尽管磁共振成像和血管造影都提供了有用信息，但彩色多普勒超声检查结果具有腘动脉假性动脉瘤的特征，只有该检查方式能够检测假性动脉瘤内的血流动力学情况。
