Brucellosis in spondyloarthritis mimicking an exacerbation

Area of Science:

• Rheumatology and Infectious Diseases
• Differential Diagnosis in Inflammatory Conditions

Background:

• Spondyloarthritis encompasses chronic inflammatory diseases affecting the axial skeleton, entheses, and peripheral joints.
• Extraarticular manifestations of spondyloarthritis include uveitis, psoriasis, and inflammatory bowel disease.
• Brucellosis is a systemic infection prevalent in specific global regions, presenting diagnostic challenges due to overlapping symptoms with other diseases.

Observation:

• A clinical case involving a patient diagnosed with both spondyloarthritis and brucellosis is presented.
• The initial clinical presentation of brucellosis in this patient closely resembled an exacerbation of their underlying spondyloarthritis.
• Key features of brucellosis mimicked the characteristic symptoms of a spondyloarthritis flare.

Findings:

• Brucellosis can present with symptoms that are difficult to distinguish from active spondyloarthritis.
• The systemic nature of brucellosis can lead to manifestations that overlap significantly with spondyloarthritis.
• This case underscores the potential for brucellosis to be misdiagnosed as a spondyloarthritis flare.

Implications:

• Clinicians should maintain a high index of suspicion for brucellosis in patients with spondyloarthritis, especially in endemic areas.
• Accurate differential diagnosis is crucial to avoid delayed or incorrect treatment for both conditions.
• Recognizing the potential for symptom mimicry can improve patient outcomes by ensuring timely and appropriate management of brucellosis and spondyloarthritis.