Abstract

Introduction: Brucellosis is one of the commonest zoonotic infections worldwide. the disease is endemic in Saudi Arabia, the Middle East, and the Mediterranean area, and whether in an endemic region or not, it remains a diagnostic puzzle due to occasional misleading unusual presentations and non-specific symptoms.

Presented here is our experience acute brucellosis at family and community medicine department FCM, Sharurah Armed Forces Hospital, Medical Services Department, Ministry of Defense and aviation, Kingdom of Saudi Arabia.

Case Presentation: A 65-year-old man presented to F&CM department complains of chronic low grade fever, joint pain and general weakness and malaise this was followed by Non-blanch able maculopapular eruptions on anterior part of tibia. He was evaluated, investigated, and managed in outpatient clinic many times without proper diagnosis. Work up for the cause of fever was inconclusive. He was diagnosed with thrombocytopenia so the patient was referred to internist, managed and discharged as a case of Idiopathic thrombocytopenia with unspecific fever. Patient came again to F&CM department with the same chronic symptoms. In absence of alternate diagnosis and clinical setting, therapy resulted in no improvement in patient's condition. Finally, the patient was evaluated by our CDC at F&CM department, requested a serological lab tests where he was diagnosed with brucellosis and treated successfully. Patients were treated with 6 week course of Doxycycline and Rifampicin with a six-month follow-up.

Conclusion: Brucellosis is an infection with multiple presentations, and whether in an endemic region or not, a thorough history of exposure and clinical suspicion are required since the misdiagnosis may lead to withholding of adequate treatment and more complications.