Department of General Medicine, Government Medical College and Hospital, Chandigarh, India.
Department of Pathology, Government Medical College and Hospital, Chandigarh, India.
Perm J. 2023 Sep 15;27(3):110-115. doi: 10.7812/TPP/23.049. Epub 2023 Aug 2.
Human brucellosis is a common zoonotic disease in certain regions of the world, especially in rural populations, yet it is often neglected. The index patient presented with prolonged fever and headache. Examination revealed hepatosplenomegaly, and investigations revealed transaminitis with bicytopenia with serological evidence positive for . The radiological picture suggested granulomatous disease with miliary nodules, and a bone marrow examination revealed a noncaseating granuloma. The case was unique and challenging, as the clinical picture was consistent with epidemiologically prevailing tuberculosis, which is also seen in brucellosis-endemic countries. Brucellosis mimicked disseminated tuberculosis, making the case intriguing to diagnose and treat. The case demonstrated that physicians need to have a high index of suspicion for brucellosis, which should be actively investigated in cases with prolonged fever. It also illustrated the fundamental importance of teamwork and the centrality of the multidisciplinary team in the planning and prioritization of treatment.
人类布鲁氏菌病是世界某些地区常见的人畜共患疾病，尤其是在农村人群中，但常常被忽视。本例患者表现为长期发热和头痛。体格检查发现肝脾肿大，检查发现肝功能异常和双系血细胞减少，血清学检查阳性。影像学提示为肉芽肿性疾病伴粟粒状结节，骨髓检查显示非干酪样肉芽肿。该病例具有独特性和挑战性，因为临床表现与流行的结核病一致，而结核病在布鲁氏菌病流行的国家也很常见。布鲁氏菌病类似于播散性结核病，这使得诊断和治疗变得有趣。该病例表明，医生需要对布鲁氏菌病保持高度怀疑，对于长期发热的患者应积极进行调查。它还说明了团队合作的重要性以及多学科团队在治疗计划和优先级制定中的核心地位。
