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Brucellosis: haemorrhagic pleural effusion
Awadh R Al-Anazi1, Shahid Aziz, Mona A Fouda
1Department of Medicine, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
Summary
Brucellosis can lead to rare hemorrhagic pleural effusion. This case highlights the need for lung decortication when medical management fails for this serious complication.
Area of Science:
- Infectious Diseases
- Pulmonology
- Internal Medicine
Background:
- Brucellosis is a zoonotic infection with diverse clinical manifestations.
- Pleural effusion is an uncommon presentation of brucellosis.
- Hemorrhagic pleural effusion is a particularly rare complication.
Observation:
- A 37-year-old female presented with fever, cough, and pleuritic chest pain.
- Physical exam revealed pleural effusion and hepatosplenomegaly.
- Laboratory tests showed pancytopenia, and pleural fluid analysis revealed an exudative effusion.
Findings:
- Blood and pleural fluid cultures confirmed Brucella species infection.
- Despite appropriate chemotherapy, the hemorrhagic pleural effusion persisted.
- Computed tomography revealed a large, loculated effusion unresponsive to repeated aspirations.
Implications:
- This case underscores brucellosis as a potential cause of hemorrhagic pleural effusion.
- Lung decortication may be necessary for refractory cases.
- Highlights the importance of considering brucellosis in endemic areas with unexplained effusions.