Brucellosis complicated by aortitis and thyroiditis: a case report

Brucellosis is a neglected and common zoonotic disease. Infections in humans result in a granulomatous disease that can affect many organs with various presentations and complications. Aortitis and thyroiditis are rare complications with limited data. This case discusses the successful medical therapy alone in the management of aortitis and the development of Brucella thyroid disease through autoimmune mechanisms.

This is a 58-year-old male patient from Jordan. He presented with prolonged fever and was found to have brucellosis associated with abdominal aortitis, subacute thyroiditis, bilateral sacroiliitis, and lumbar spondylodiskitis. We review his clinical course with an emphasis on the complications of aortitis and thyroiditis. The aortitis was managed conservatively with antibiotics alone, avoiding surgical or endovascular intervention. The subacute thyroiditis was associated with autoimmune markers and was detected in the setting of an underlying pre-existing multinodular goiter. After a long follow-up period of three years, the patient continued to do well.

Physicians should be aware of the complications of aortitis and thyroiditis in patients with brucellosis. Medical therapy alone can be an option for some patients with aortitis who are at high surgical risk. In addition, the development of subacute thyroiditis in the setting of brucellosis might be secondary to an autoimmune response.