Dutto Luca, Pomero Fulvio, Allione Attilio
S, Croce e Carle Hospital, Emergency Department, via Coppino 26, Cuneo, 12100, Italy.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2008.0243. Epub 2009 Feb 27.
We report a case of metastatic abscesses caused by a chronic form of brucellosis in a shepherd. When she was admitted the patient was cachectic with haematological signs of phlogosis. An abdominal computed tomography scan revealed the presence of multiple hepatic and renal abscesses with a fluid mass in the abdominal wall. The blood cultures, tuberculin skin test, and Wright reaction all gave negative results, but the brucellosis Coombs test for Brucella species was highly positive. Diagnosis was confirmed by a high titre of anti-Brucella IgM antibodies. The patient started antibiotic treatment with a progressive clinical improvement, but after discharge she was lost to follow-up and died 7 months later.
我们报告一例由慢性布鲁氏菌病引起的转移性脓肿病例,患者为一名牧羊人。入院时,患者消瘦,有炎症的血液学体征。腹部计算机断层扫描显示肝脏和肾脏有多个脓肿,腹壁有液性肿块。血培养、结核菌素皮肤试验和瑞特反应均为阴性,但布鲁氏菌属的布鲁氏菌病库姆斯试验呈强阳性。高滴度的抗布鲁氏菌IgM抗体确诊了该病。患者开始接受抗生素治疗,临床症状逐渐改善,但出院后失访,7个月后死亡。