Chronic brucellosis with sacroiliitis: A case report

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL

Clinical Case Reports Pub Date : 2024-11-08 DOI:10.1002/ccr3.9525

Bibek Shrestha, Pradeep Shrestha, Sudip Bastakoti, Prahlad Gupta, Shiva Ram Ale Magar

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Abstract

Key Clinical Message

Brucellosis, especially with osteoarticular involvement, is uncommon and difficult to diagnose, but it should be considered in a case presenting with prolonged fever, joint pain, and back pain. The diagnosis requires a combination of history, serological examinations, and radiographic studies. When the condition is detected and treated early, the prognosis is good.

Brucella exploits host immune defenses to establish the chronic infection brucellosis, an endemic zoonotic disease. While human brucellosis affects multiple organs, osteo articular involvement is rare. We report the case of a 41-year-old woman with a history of goat farming who presented with fewer associated with low back pain and multiple joint pain for 4 months. Brucellosis was documented by positive serological tests (ELISA). Radiological findings suggested of right sacroiliitis and fracture line on the right sacral ala though had no history of trauma. Treatment consisted of NSAIDs and multiple antibiotic therapy. At follow-up, her low back pain, joint pain, and fever had subsided. After 4 weeks of follow-up, her symptoms were completely relieved with no recurrence. Brucellosis with atypical localization should be considered with a high index of suspicion based on detailed history and physical examination to ensure timely diagnosis and treatment.

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慢性布鲁氏菌病伴骶髂关节炎：病例报告

关键临床信息：布鲁氏菌病，尤其是累及骨关节的布鲁氏菌病并不常见，也很难诊断，但如果病例出现长期发热、关节痛和背痛，则应考虑该病。诊断需要结合病史、血清学检查和影像学检查。摘要：布鲁氏菌利用宿主的免疫防御功能建立慢性感染布鲁氏菌病，这是一种地方性人畜共患病。虽然人类布鲁氏菌病会影响多个器官，但骨关节受累却很少见。我们报告了一例 41 岁妇女的病例，她有山羊养殖史，4 个月来腰痛和多处关节痛症状较轻。布鲁氏菌病血清学检测（ELISA）呈阳性。放射学检查结果显示她患有右侧骶髂关节炎，右侧骶骨上有骨折线，但无外伤史。治疗包括非甾体抗炎药和多种抗生素治疗。随访时，她的腰痛、关节痛和发烧症状已经缓解。随访 4 周后，她的症状完全缓解，且没有复发。在考虑非典型定位的布鲁氏菌病时，应根据详细的病史和体格检查高度怀疑，以确保及时诊断和治疗。

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来源期刊

Clinical Case Reports MEDICINE, GENERAL & INTERNAL-

自引率

14.30%

发文量

1268

审稿时长

13 weeks

期刊介绍： Clinical Case Reports is different from other case report journals. Our aim is to directly improve global health and increase clinical understanding using case reports to convey important best practice information. We welcome case reports from all areas of Medicine, Nursing, Dentistry, and Veterinary Science and may include: -Any clinical case or procedure which illustrates an important best practice teaching message -Any clinical case or procedure which illustrates the appropriate use of an important clinical guideline or systematic review. As well as: -The management of novel or very uncommon diseases -A common disease presenting in an uncommon way -An uncommon disease masquerading as something more common -Cases which expand understanding of disease pathogenesis -Cases where the teaching point is based on an error -Cases which allow us to re-think established medical lore -Unreported adverse effects of interventions (drug, procedural, or other).