A Rare Case of Focal Brucellosis With Multiple Complications: A Case Report



Salami Khaneshan A ; Jafari S ; Sohrabi M ; Masoumzadeh N
Source: Journal of Babol University of Medical Sciences Published:2025

Abstract

Background and Objective: Brucellosis is a worldwide zoonotic infection, well recognized for its diversity of manifestations. This case report highlights a rare presentation of brucellosis with acetabulofemoral monoarthritis, iliopsoas pyomyositis, and abscess, emphasizing the importance of early diagnosis, appropriate treatment, and follow-up. Case Report: A 35-year-old male rancher with a history of zoonotic exposure presented with a 45-day history of left inguinal pain radiating to the lumbar region, fever, and restricted movement in the left hip. His symptoms had progressively worsened despite initial treatment with antibiotics. He had a prior episode of brucellosis 18 months earlier, but prematurely discontinued treatment after partial improvement. Physical examination revealed tenderness, swelling, and movement limitation in the left hip. Laboratory tests indicated elevated inflammatory markers, and imaging studies suggested focal brucellosis with chronic monoarthritis and pyomyositis. Synovial fluid analysis confirmed Brucella melitensis via polymerase chain reaction (PCR), and the patient was diagnosed with brucellosis complicated by acetabulofemoral monoarthritis and iliopsoas abscess. Surgical drainage was performed, and the patient was started on a combination of doxycycline and rifampin. He showed significant improvement, with full resolution of symptoms after a 12-week antibiotic regimen. Conclusion: The results of the present study demonstrated that focal brucellosis, though rare, can lead to significant morbidity if not promptly diagnosed and treated. This case demonstrates the necessity of early intervention and prolonged treatment in preventing chronic and relapsing disease. Clinicians should remain vigilant for atypical presentations, especially in patients with occupational exposure and previous episodes of brucellosis. © 2024 Babol University of Medical Sciences. Published by Babol University of Medical Sciences.