Case report

Acase report of brucellosis and sacroiliitis with clinical and epidemiological overview

Zoran Barušić ; Klinika za infektivne bolesti Dr.Fran Mihaljević
Rok Čivljak orcid.org/0000-0001-8766-7438 ; Klinika za infektivne bolesti Dr.Fran Mihaljević
Tomislav Maretić ; Klinika za infektivne bolesti Dr.Fran Mihaljević
Miroslav Lisić ; Klinika za infektivne bolesti Dr.Fran Mihaljević
Željko Cvetnić ; Hrvatski veterinarski institut, Zagreb
Ratimir Petrović ; KBC Zagreb, Zavod za nuklearnu medicinu i zaštitu od zračenja, Zagreb

Abstract

Brucellosis is a zoonotic infectious disease found in some domestic and wild animals that in rare cases may be transmitted to humans as well. A patient from Bosnia and Herzegovina was admitted to our hospital for unclear etiology of recurrent intermittend fever lasting for almost two months accompanied by pain in the back and lower extremities causing his inability to move. The patient was at first hospitalized in a surgical clinic where spine and hip radiogram was performed as well as multislice computer tomography and magnetic resonance imaging of the spine that showed disc protrusion at L5/S1, but not the underlying cause of disease. Therefore, he was transferred to our hospital for further examination and treatment. Additional patient history revealed that the patient lived on a homestead where he raised sheep which is why brucellosis was suspected. Brucellosis diagnosis was confirmed by serological testing, PCR and isolation of Brucella mellitensis from the patient’s bood sample, and skeletal scintigraphy showed a pathological accumulation of radioactive agents in the sacroiliac joints. Acombined antimicrobial therapy lasting for eight weeks was administered: a combination of doxycycline and rifampicin for six weeks, then additional two weeks of doxycycline and ciprofloxacin. The patient was discharged from hospital in good general condition, without fever, able to move and without disease symptoms. This case report underlines the importance of collecting epidemiological data as well as considering brucellosis in patients coming from neighbouring countries where brucellosis is common. Veterinary measures for brucellosis control and surveillance in animals as well as surveillance of cattle imported from neighbouring countries are most important preventive measures for disease transmission among humans.

Keywords

brucellosis; sacroiliitis; diagnostics; serology; PCR; scintigraphy

Hrčak ID:

30540

URI

https://hrcak.srce.hr/30540

Publication date:

3.9.2008.

Article data in other languages: croatian

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