Yumn Ahmed Elsabagh
Kasr Alainy-Cairo University, Egypt
Title: Brucellosis, do not miss: A case report
Biography
Biography: Yumn Ahmed Elsabagh
Abstract
Brucellosis is a zoonotic infection which still remains as a major health problem in the Mediterranean region and the Middle East. Two case reports were described. Case (1): A 40 years old female, known rheumatic heart disease with mitral valve replacement 23 years ago. She complained of fever for one year, arthritis of wrists, knees, ankles and low back pain. Four months later, she complained of left upper abdominal pain. By examination temperature was 40°C, looks pale, cardiac examination showed mixed mitral valve disease, abdomen showed tender splenomegaly and joint examination showed tenderness at wrists, knees, ankles and lumber spine. ESR 120, CRP: 96. TEE showed freely mobile mass attached to mitral valve. Blood culture showed MRSA and received antibiotics according to culture but without improvement. A presumptive diagnosis of Brucella Endocarditis was made. Brucella abortus: 1/640, Brucella mullitens: 1/320. We started streptomycin, doxycycline and rifampicin. After two weeks the patient clinical condition markedly improved, and after three months of treatment the vegetation resolved. Case (2): A female patient 20 years old, complained of diarrhea and fever reaching 40°C. After one week the patient complained of bilateral symmetrical arthritis of wrists, MCPs, PIPs, Knees and ankles with low back pain. Her lab showed HG 9, TLC: 19 with absolute neutrophilia. CRP: 98, ESR: 5, ANA, Anti DNA, Anti smith, Anti Jo, RF, Anti CCP, Anti SSA, Anti SSB, were negative. Blood culture showed Staphylococcus aureus. She received antibiotics according to culture without improvement. A presumptive diagnosis of Brucella arthritis was made. Brucella abortus: 1/640, Brucella mullitens: 1/640. We started doxycycline and rifampicin and the patient arthritis improved after two weeks.