Brucellosis acquired by eating imported cheese.

Area of Science:

• Infectious Diseases
• Clinical Medicine
• Microbiology

Background:

• Pyrexia of unknown origin (FUO) presents a diagnostic challenge in pediatric and adult medicine.
• Brucellosis is a significant zoonotic infection, typically associated with travel to endemic areas.
• Great Britain is officially recognized as a brucellosis-free country.

Observation:

• A 14-year-old boy presented with persistent fever without an identifiable cause.
• The patient had no recent international travel history, having remained in Great Britain for six years.
• Initial investigations for FUO did not yield a conclusive diagnosis.

Findings:

• The diagnosis of Brucella melitensis infection was established after detailed and repeated history-taking.
• This case demonstrates a rare instance of indigenous Brucella infection in a brucellosis-free region.
• The specific route of transmission in this case remained undetermined but was suspected to be linked to local environmental exposure.

Implications:

• This case underscores the importance of comprehensive patient history, even in seemingly low-risk populations.
• It highlights the potential for Brucella melitensis to cause FUO in non-endemic regions.
• Clinicians should maintain a high index of suspicion for uncommon infections when managing FUO, irrespective of geographical location or travel history.