Brucella multi-organ involvement in a patient with negative serologic tests: case report

Abstract number: 1733_1021

Khorvash F., Hassanzadeh Keshteli A., Behjati M., Salehi M., Ataei B.

Background: Brucellosis is a multi-system disease that may present with a broad spectrum of clinical manifestations. Whilst hepatic involvement in brucellosis is not rare, it may rarely, involve the kidney or present with cardiac manifestations. Central nervous involvement in brucellosis some times can cause demyelinating syndromes. Here we present a case of brucella hepatitis, myocarditis, acute disseminated encephalomyelitis, and renal failure.

Case presentation: A 26 year old man presented with fever, ataxia, and dysarthria. He was a shepherd and gave a history of low grade fever, chilly sensation, cold sweating, loss of appetite, arthralgia and 10 Kg weight loss during previous 3 months. He had a body temperature of 39°C at the time of admission. On laboratory tests he had elevated levels of liver enzymes, blood urea nitrogen, Creatinine, Creatine phosphokinase (MB), and moderate proteinuria. He had abnormal echocardiography and brain MRI too. Coombs test and enzyme-linked immunosorbent assay for IgG, IgM were negative. Standard tube agglutination test (STAT) and 2-mercaptoethanol (2-ME) titers were 1:80 and 1:40 respectively. Finally he was diagnosed with brucellosis by positive blood culture and polymerase chain reaction for Brucella melitensis.

Conclusion:Brucella infection should be ruled out in patients with multi-organ involvement, especially in ones from endemic regions. We can come to this conclusion that we may not be in the safe side from brucellosis only with low STAT and 2-ME titers and other diagnostic methods like blood culture and PCR should be administered to rule out brucellosis.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Location: ICC, Munich, Germany
Presentation type:
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