Infectious Diseases, Bacteriology and Antibiotics

Biography

Biography: Abdulla Al Amoudi

Abstract

Brucellosis is a systemic infection with a broad clinical spectrum, ranging from asymptomatic disease to severe or fatal illness. The incubation period is usually one to four weeks; occasionally, it may be as long as several month. we descripe a case of a 55 year old housewife presented with a complain of fever, nausea, vomiting, profuse sweating, malaise, headache, muscle fatigue and weight loss since 2 months. She was seen initially in different hospital and was given antibiotics (Amoxcicillin and Clavulanate acid) but she was not compliant with it. Past history is significant for diabetes since 8 years on Vildagliptin/Metformin and Glimpiride, stroke since 2 month ago on aspirin, hyperlipidaemic on rosuvastatin, and hypertensive for 2 years on Amlodopine/Valsartan/Hydrochlorothiazide. Physical examination showed a sick, pale female, with blood pressure of 118/67 mmHg, temperature of 38 degC, hepatosplenomegaly. Otherwise normal exam. Laboratory showed low hemoglobin, hematocrit and Mean corpuscular volume. High Red blood cell distribution width.  Normal white blood cell count and platelets. High ESR and CRP. Chest X ray normal. Mildly elevated liver enzymes. Positive CMV and EBV IgG. At this point, we suspected either infectious cause, malignancy or connective tissue disease. Patient went further investigations. Peripheral blood smear showed 1+ Anisocytosis, Polychrom, Hypochromasia. Abdominal ultrasound showed hepatomegaly measuring 21.4 cm with mild splenomegaly. Blood culture came back positive for Brucella species (Gram Negative Coccobacilli). Upon further questioning, patient admits to handling and preparing uncooked camel meat. A diagnosis of brucellosis was made. She was eventually prescribed rifampicine combined with doxycycline for 6 consecutive weeks.