Emergency Department, Santa Croce and Carle General Hospital, Cuneo, Italy; School of Emergency Medicine, University of Turin, Turin, Italy.
Lancet Infect Dis. 2013 Nov;13(11):987-93. doi: 10.1016/S1473-3099(13)70197-X.
We present a case of hepatic abscess caused by Brucella melitensis (or hepatic brucelloma) diagnosed in a 59-year-old man 33 years after an episode of acute brucellosis that had completely resolved. Recovery from symptoms and a decrease in lesion size seen on radiological assessment were achieved through prolonged combined antibiotic therapy, without the need for surgery. Hepatic brucelloma is a rare complication of brucellosis, which is the most common zoonosis globally, mainly occurring in specific endemic areas and causing a range of clinical manifestations. In this Grand Round, we review the clinical manifestations, diagnostic approach (through laboratory, radiology, and histology findings), differential diagnosis, treatment, and prognosis of hepatic brucelloma.
我们报告了 1 例布鲁氏菌病(或肝布氏菌瘤)引起的肝脓肿,患者为 59 岁男性,在急性布鲁氏菌病完全痊愈 33 年后发病。通过延长联合抗生素治疗,患者症状缓解,影像学评估显示病变缩小,无需手术。肝布氏菌瘤是布鲁氏菌病的罕见并发症,布鲁氏菌病是全球最常见的动物源性传染病,主要发生在特定的流行地区,引起多种临床表现。在本次大查房中,我们回顾了肝布氏菌瘤的临床表现、诊断方法(通过实验室、影像学和组织学发现)、鉴别诊断、治疗和预后。