Paitoonpong Leilani, Ekgatat Monaya, Nunthapisud Pongpun, Tantawichien Terapong, Suankratay Chusana
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2006 Aug;89(8):1313-7.
Brucellosis remains a major zoonotic disease worldwide. It has never been reported at King Chulalongkorn Memorial Hospital (KCMH). The authors describe the first case of brucellosis in KCMH, and also review all previous reports in Thailand. The presented case was a 52-year-old Thai man, living in Phetchabun Province, who was diagnosed with idiopathic pulmonary fibrosis two years prior to admission. He presented with prolonged fever, dry cough, weight loss of eight kg over three months, hepatosplenomegaly, and pancytopenia. Blood and bone marrow cultures grew Brucella melitensis at 72 hours of incubation. A slide agglutination (Rose Bengal) test was also positive for Brucella antibody. He had been exposed to contaminated placenta of his goats that had spontaneous abortion in the past few months before his illness. The patient was successfully treated with gentamicin, doxycycline, and rifampicin. Clinicians should have a high index of suspicion when evaluating patients presenting with prolonged fever and having an exposure risk of brucellosis.
布鲁氏菌病仍是全球主要的人畜共患病。朱拉隆功国王纪念医院（KCMH）此前从未报告过该病例。作者描述了KCMH首例布鲁氏菌病病例，并回顾了泰国以往的所有报告。该病例为一名52岁的泰国男子，居住在彭世洛府，入院前两年被诊断为特发性肺纤维化。他出现长期发热、干咳、三个月内体重减轻8公斤、肝脾肿大和全血细胞减少。血液和骨髓培养在培养72小时后培养出羊布鲁氏菌。玻片凝集（玫瑰红）试验布鲁氏菌抗体也呈阳性。他在患病前几个月接触过其山羊受污染的胎盘，这些山羊发生了自然流产。该患者通过庆大霉素、强力霉素和利福平成功治愈。临床医生在评估出现长期发热且有布鲁氏菌病暴露风险的患者时应保持高度怀疑。
