Odeh Aya, Alkhaled Farah, Soudi Shatha
Ophthalmology, The University of Jordan, Amman, JOR.
Pediatrics, The University of Jordan, Amman, JOR.
Cureus. 2024 Nov 21;16(11):e74147. doi: 10.7759/cureus.74147. eCollection 2024 Nov.
Brucellosis is an infectious disease caused by bacteria of the genus , predominantly affecting livestock and humans through contact or consumption. It is a major public health challenge, particularly in developing countries. Symptoms can be mild to severe, making diagnosis difficult and often resulting in more chronic problems if those issues are not addressed. Our case report is about a patient with brucellosis who ended up having multiple organ involvement and focusing on the benefits of early diagnosis and management. Our case report discusses a 61-year-old Jordanian male patient with a significant medical history, including heart failure, diabetes, and hypertension, who was admitted for left ankle pain, redness, and swelling after a recent travel to Italy. His symptoms began four months prior with abdominal pain, fever, anemia, and persistent gastrointestinal issues, worsening despite oral antibiotics. He developed progressive thigh pain and was ultimately diagnosed with septic arthritis, experiencing ongoing fever and new anemia. Blood tests indicated elevated erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and leukocytosis levels, while cultures were negative. Imaging revealed fluid collections around the right iliac and gluteus minimus muscles. A diagnosis of brucellosis was confirmed through lab tests. Management included doxycycline 100 mg and rifampicin 600 mg as part of the treatment protocol, hydration support, pain relief, and imaging-guided drainage to address the infection and its complications. In conclusion, this case highlights the diverse manifestations of brucellosis, including atypical symptoms such as fever of unknown origin (FUO), septic arthritis, and iliacus abscess. Studies underscore the need to consider brucellosis in the differential diagnosis of FUO, especially in endemic regions. A multidisciplinary management approach and a high level of clinical suspicion are crucial for achieving optimal outcomes in patients with this complex infection.
布鲁氏菌病是一种由布鲁氏菌属细菌引起的传染病，主要通过接触或食用感染家畜和人类。它是一项重大的公共卫生挑战，在发展中国家尤为如此。症状可轻可重，诊断困难，如果这些问题得不到解决，往往会导致更慢性的问题。我们的病例报告是关于一名患有布鲁氏菌病的患者，该患者最终出现多器官受累，并着重介绍了早期诊断和治疗的益处。我们的病例报告讨论了一名61岁的约旦男性患者，他有重要的病史，包括心力衰竭、糖尿病和高血压，近期前往意大利旅行后因左踝疼痛、红肿和肿胀入院。他的症状始于四个月前，出现腹痛、发热、贫血和持续的胃肠道问题，尽管服用了口服抗生素，症状仍在恶化。他逐渐出现大腿疼痛，最终被诊断为化脓性关节炎，持续发热并出现新的贫血。血液检查显示红细胞沉降率（ESR）、C反应蛋白（CRP）升高以及白细胞增多，而培养结果为阴性。影像学检查显示右髂肌和臀小肌周围有积液。通过实验室检查确诊为布鲁氏菌病。治疗方案包括使用强力霉素100毫克和利福平600毫克，同时给予补液支持、止痛治疗以及影像引导下的引流，以处理感染及其并发症。总之，该病例突出了布鲁氏菌病的多种表现形式，包括不明原因发热（FUO）、化脓性关节炎和髂肌脓肿等非典型症状。研究强调在FUO的鉴别诊断中需要考虑布鲁氏菌病，特别是在流行地区。多学科管理方法和高度的临床怀疑对于实现这种复杂感染患者的最佳治疗效果至关重要。
