Hegde Nandana N, G Hariharan, Asif Mohd, Gaddamedi Sravan Kumar, S Yughandar, Kutty Sharada V
Department of General Medicine, All India Institute of Medical Sciences, Mangalagiri, Mangalagiri, IND.
Department of Cardiology, All India Institute of Medical Sciences, Mangalagiri, Mangalagiri, IND.
Cureus. 2025 May 8;17(5):e83702. doi: 10.7759/cureus.83702. eCollection 2025 May.
A 58-year-old male farmer from southern India with a history of diabetes mellitus presented with a one-year history of fever and progressive lower back pain. He was initiated on antitubercular therapy (ATT) for suspected tuberculous spondylitis. Despite three months of ATT, his symptoms worsened, with progressive constitutional symptoms and features of heart failure. Further evaluation revealed aortic valve vegetation and persistent lumbar spondylodiscitis. Serological and imaging findings, along with occupational exposure to livestock, led to a diagnosis of brucellosis with infective endocarditis and spondylodiscitis. The patient's condition deteriorated despite supportive care and antibiotics as per treatment guidelines. This case highlights the diagnostic challenges of brucellosis in endemic regions and underscores the importance of considering zoonotic infections in patients with atypical presentations of spondylodiscitis and endocarditis, in regions where both tuberculosis and brucellosis are endemic.
一名来自印度南部的58岁男性农民，有糖尿病病史，出现发热和进行性下背部疼痛1年。他因疑似结核性脊柱炎开始接受抗结核治疗（ATT）。尽管进行了3个月的ATT，他的症状仍恶化，出现进行性全身症状和心力衰竭特征。进一步评估发现主动脉瓣赘生物和持续性腰椎椎体间盘炎。血清学和影像学检查结果，以及职业性接触家畜，导致诊断为布鲁氏菌病合并感染性心内膜炎和椎体间盘炎。尽管按照治疗指南给予了支持治疗和抗生素，患者的病情仍恶化。该病例凸显了地方流行区布鲁氏菌病的诊断挑战，并强调在结核病和布鲁氏菌病均为地方流行的地区，对于椎体间盘炎和心内膜炎非典型表现的患者，考虑人畜共患感染的重要性。
