A case of brucellosis with perinephritis presented as abdominal and low back pain in China

Background

Human brucellosis, a zoonotic infection, typically manifests as fever, fatigue, anorexia, and osteoarticular pain. We report a rare case of brucellosis complicated by perinephritis, presenting with abdominal and low back pain.

Case presentation

A 74-year-old male presented with fever, abdominal and low back pain. Initial lumbar magnetic resonance imaging (MRI) demonstrated L4–5 disc herniation with foraminal and spinal canal stenosis, while abdominal computed tomography (CT) revealed perinephric inflammation without structural abnormalities. Upon developing intermittent fever (38 °C), epidemiological history uncovered chronic consumption of uninspected sheep meat. Brucellosis with perinephritis was confirmed via supportive Brucella agglutination test and blood culture.

Conclusions

Perinephritis is an uncommon complication of brucellosis, and atypical abdominal pain warrants consideration of zoonotic exposure. Serological testing (agglutination test) and blood culture remain critical for timely diagnosis in high-risk patients.