Brucellosis, the Forgotten Endemic: A Clinical Case Report

Brucellosis is a disease caused by an intracellular Gram-negative coccobacillus, which presents nonspecific symptoms and is difficult to diagnose. There are several species of the genus Brucella currently known involved in its pathogenesis. In Portugal, in the Bragança district, Brucella melitensis stands out as an infection agent. Since the 1990s, diagnostic tests associated with brucellosis have become more regularly part of clinical and laboratory practice. In recent years, several new cases of brucellosis have been identified in humans within the Local Health Unit of the Northeast (ULSNE), its total area of influence being the district of Bragança in Portugal. As for the number of positive serological tests on animals, these have also been high. The clinical case presented follows a regional pattern, involving a 41-year-old female patient who sought emergency care due to low back pain and weight loss, three to four weeks ago, after ingesting artisanal fresh cheese. The Rose Bengal test was performed and monitored with the Wright reaction, which allowed the diagnosis and respective treatment with double antibiotic therapy to be made. Despite the therapy and measures implemented, the clinical picture evolved unfavorably, with the emergence of new complications. Due to its non-specific clinic, brucellosis is a current underdiagnosed disease, which is why it is necessary to insist on training and clinical screening of people and animals. It is also essential to support research projects in the field of zoonoses as well as sharing information with other regions or countries that experience these realities, thus allowing for a better understanding and management of these diseases.