Endophlebitis of the leg caused by brucella infection

Brucellosis is hyperendemic in Saudi Arabia where, despite rapid urbanisation, a large segment of the population has a nomadic background and clings to cultural traditions such as the drinking of raw milk. We report here an unusual complication of brucellosis in a microbiology technologist. A 41-year-old male presented with an 8-day history of right ankle pain which, over a 3-day period, extended up to his calf where swelling and tightness developed. The leg symptomatology occurred on a background of fever, seats and rigors. X-ray of the limb was normal but a venogram revealed thrombosis of the deep veins of the right calf. Although his blood culture was negative, he developed high brucella antibody titres. Treatment with anticoagulants combined with a course of doxycycline and rifampin produced a full recovery.