Wang Miaoqian, Zhu Qingli, Yang Qian, Li Wenbo, Wang Xinning, Liu Wei, Zhou Baotong, Li Zhenghong, Yang Hong
aPeking Union Medical College Hospital, Chinese Academy of Medical Sciences bCapital Institute of Pediatrics, Beijing, China.
Medicine (Baltimore). 2017 Jan;96(2):e5893. doi: 10.1097/MD.0000000000005893.
Brucellosis is a multisystem infection found worldwide that has a broad range of characteristics, which range from acute fever and hepatomegaly to chronic infections that most commonly affect the central nervous system, cardiovascular system, or skeletal system. Gastrointestinal and splanchnic artery involvements in brucellosis are relatively uncommon.
We report a case of brucellosis in an adolescent presenting as intermittent abdominal pain, diarrhea, and fever, with intestinal tract involvement. And stenosis of the celiac artery and the superior mesenteric artery was found after exposed to risk factors of Brucella infection. Splanchnic vessels stenosis and an endothelial lesion may exacerbate the prevalent symptom of abdominal pain, as a form of colic pain, occurring after eating.
The patient was diagnosed as brucellosis. The narrowing of the SMA and CA was suspected to be vasculitis secondary to the brucellosis.
The patient was treated with minocycline and rifampicin for 12 weeks totally.
The gastrointestinal manifestations of brucellosis recovered rapidly under intensive treatment. However, follow-up imaging revealed that the superior mesenteric artery and celiac artery stenosis was unimproved.
In brucellosis, gastrointestinal manifestations may be the only observable features of the disease. Splanchnic arterial stenosis is a rare complication of brucellosis. Sonography and computed tomography may be useful for both diagnosis and follow-up.
布鲁氏菌病是一种在全球范围内发现的多系统感染疾病，具有广泛的特征，从急性发热和肝肿大到慢性感染，慢性感染最常影响中枢神经系统、心血管系统或骨骼系统。布鲁氏菌病累及胃肠道和内脏动脉相对少见。
我们报告一例青少年布鲁氏菌病病例，表现为间歇性腹痛、腹泻和发热，伴有肠道受累。在接触布鲁氏菌感染危险因素后，发现腹腔干动脉和肠系膜上动脉狭窄。内脏血管狭窄和内皮病变可能会加重进食后出现的以绞痛形式为主的腹痛这一常见症状。
该患者被诊断为布鲁氏菌病。怀疑肠系膜上动脉和腹腔干动脉狭窄是布鲁氏菌病继发的血管炎。
患者接受米诺环素和利福平治疗，共12周。
在强化治疗下，布鲁氏菌病的胃肠道表现迅速恢复。然而，随访影像学检查显示肠系膜上动脉和腹腔干动脉狭窄未改善。
在布鲁氏菌病中，胃肠道表现可能是该疾病唯一可观察到的特征。内脏动脉狭窄是布鲁氏菌病罕见的并发症。超声检查和计算机断层扫描对诊断和随访可能有用。
