Diagnostic challenges of human brucellosis in Hong Kong: a case series in two regional hospitals

A retrospective analysis of six patients diagnosed with brucellosis in two regional hospitals was carried out. The epidemiological, clinical, and laboratory features were studied. All patients had exposure history. Three patients presented with musculoskeletal symptoms, while three had predominantly genitourinary symptoms. One patient did not have fever at presentation. All patients were diagnosed by positive blood culture of Brucella melitensis, and the diagnosis was not suspected for all except one patient at presentation. Given the inferior sensitivity of blood culture to serology, human brucellosis may be underdiagnosed, especially when the index of suspicion is low.