Hollow viscus perforation secondary to brucellosis: a rare case report

Brucellosis, a zoonotic infection, rarely causes hollow viscus perforation. This case highlights ileal perforation in a patient with pre-diagnosed brucellosis, which reinforces the importance of early surgical evaluation in an acute abdomen.

A young male with confirmed brucellosis (positive IgM serology) presented with fever and arthralgia. On day 2 of admission, he developed sudden severe abdominal pain, guarding, and rigidity. Imaging revealed pneumoperitoneum, prompting emergency laparotomy, which identified an ileal perforation. Wedge resection and anastomosis was performed, followed by combined antibiotics. Histopathology showed transmural inflammation with ulceration. The patient recovered fully postoperatively.

Brucellosis typically manifests with systemic symptoms; gastrointestinal involvement is uncommon. This case demonstrates ileal perforation without prior Gastrointestinal (GI) symptoms, likely due to ulceration. Early imaging and surgical intervention were crucial. In endemic regions, brucellosis should be considered in an acute abdomen with prolonged fever associated with arthralgia.

Although rare, brucellosis can lead to life-threatening perforation. A high index of suspicion, prompt imaging, and timely surgery are vital for optimal outcomes, alongside prolonged antibiotic therapy.