Brucellosis and tuberculosis: clinical overlap and pitfalls

Area of Science:

• Infectious Diseases
• Microbiology
• Clinical Medicine

Background:

• Brucellosis and tuberculosis (TB) are significant global health concerns.
• Both diseases can present with non-specific symptoms, leading to diagnostic challenges.
• Co-infection or misdiagnosis can impact treatment efficacy and patient outcomes.

Purpose of the Study:

• To delineate characteristic clinical and laboratory features of tuberculosis in patients with culture-proven brucellosis.
• To highlight the diagnostic overlap between brucellosis and tuberculosis.
• To emphasize the importance of excluding tuberculosis in brucellosis patients.

Main Methods:

• Retrospective analysis of patients with culture-proven brucellosis (January-December 2011).
• Exclusion of patients with confirmed co-infection with tuberculosis.
• Review of clinical features, laboratory parameters, and histopathology reports.

Main Results:

• Thirty-two brucellosis patients were analyzed; 65.63% had chronic fever, 40.63% had productive cough.
• Hepatomegaly (46.88%) and splenomegaly (37.50%) were common findings.
• Elevated ESR and hypergammaglobulinemia were observed in 25% of patients; granulomas noted in biopsies.

Conclusions:

• Brucellosis and tuberculosis exhibit significant overlap in clinical presentation and laboratory findings.
• Thorough exclusion of tuberculosis is imperative in suspected or confirmed brucellosis cases.
• Early differentiation prevents inappropriate antimicrobial therapy and mitigates the risk of drug-resistant tuberculosis.