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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
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Cellulitis in human brucellosis: An atypical presentation.

K Subramaniam1, S U Ali

  • 1Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Medical Microbiology and Immunology, Cheras 56000, Kuala Lumpur, Malaysia. kasturimicrob@gmail.com.

The Malaysian Journal of Pathology
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Human brucellosis, a rare zoonotic disease in Malaysia, presented atypically in a young man with skin lesions. Diagnosis was confirmed via blood culture of Brucella melitensis, highlighting the importance of considering this infection.

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Area of Science:

  • Infectious Diseases
  • Zoonotic Diseases
  • Clinical Microbiology

Background:

  • Brucellosis is a zoonotic infection with diverse clinical presentations, often challenging to diagnose in humans.
  • Human brucellosis is infrequently reported in Malaysia, making it an uncommon diagnosis in the region.

Observation:

  • A 19-year-old male presented with fever and lower limb erythema, initially misdiagnosed as cellulitis.
  • The patient had a history of consuming raw goat's milk and undercooked meat, potential sources of Brucella melitensis transmission.

Findings:

  • Blood cultures confirmed Brucella melitensis infection.
  • Positive Brucella serology (IgM and IgG) and a high titer (1:2560) on the anti-Brucella immunocapture agglutination test (BrucellaCapt) supported the diagnosis.
  • The patient exhibited atypical cutaneous involvement, a rare manifestation of human brucellosis.

Implications:

  • This case underscores the importance of considering brucellosis in patients with unexplained febrile illnesses and atypical symptoms, even in low-prevalence areas.
  • Early and accurate diagnosis of brucellosis is crucial for effective treatment and preventing complications.
  • The case highlights the need for increased awareness among clinicians regarding zoonotic diseases and their varied presentations.