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Spontaneous bacterial peritonitis due to Brucella in an HBV-positive cirrhotic patient

Yasemin Çakır Kıymaz1, Sümeyye Kara Yeşildağ1, Sevgi Baltacı2

  • 1Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|February 28, 2025
PubMed

Insights

Brucellosis is a rare cause of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. This case highlights successful treatment of Brucella-induced SBP with doxycycline and rifampicin.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Microbiology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a serious complication in cirrhosis patients.
  • Escherichia coli and Klebsiella pneumoniae are the most frequent pathogens causing SBP.
  • Brucellosis is an uncommon etiology for peritonitis.

Observation:

  • A 30-year-old male with chronic hepatitis B presented with symptoms suggestive of SBP.
  • Blood and peritoneal fluid cultures identified Brucella species.
  • The patient experienced fever, night sweats, weight loss, abdominal pain, and distension.

Findings:

  • Brucella spp. was successfully isolated from blood and peritoneal fluid.
  • The patient achieved full recovery after a six-week course of doxycycline and rifampicin.
  • No recurrence or complications were noted during the follow-up period.

Implications:

  • Brucellosis should be considered in the differential diagnosis of SBP, especially in endemic areas.
  • Effective antibiotic regimens including doxycycline and rifampicin can successfully treat Brucella-induced SBP.
  • This case underscores the importance of microbiological diagnosis for guiding appropriate therapy in complex cirrhotic patients.
Keywords:
BrucellosisHepatitis BPeritonitis

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