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[Brucellosis with fatal endotoxic shock]

S Kress1, P Klooker, V Kaufmann

  • 1Medizinische Klinik C, Klinikum Ludwigshafen.

Medizinische Klinik (Munich, Germany : 1983)
|December 31, 1997
PubMed
Summary

Early diagnosis of brucellosis is crucial for treatment success. This case highlights the diagnostic challenges and fatal complications, including endotoxic shock, associated with human brucellosis.

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Area of Science:

  • Veterinary Medicine
  • Infectious Diseases
  • Human Pathology

Background:

  • Brucellosis, a zoonotic disease, often presents diagnostic challenges despite its generally good prognosis with early detection.
  • Timely and accurate diagnosis remains a significant hurdle in managing brucellosis effectively.

Observation:

  • A 60-year-old butcher presented with undulating fever, sweats, arthralgia, and weight loss.
  • Clinical examination revealed hepatosplenomegaly, hepatitis, and multiple focal liver lesions on imaging.
  • Histopathology showed caseous granulomas, and Brucella species were confirmed via prolonged blood culture incubation.

Findings:

  • The patient developed endotoxic shock within 24 hours of initiating antibiotic therapy (tetracycline and quinolones).
  • Multiorgan failure and disseminated intravascular coagulation led to a fatal outcome.
  • This case represents the first reported instance of human brucellosis associated with lethal endotoxic shock.

Implications:

  • Undulating fever with liver involvement necessitates considering brucellosis in differential diagnoses.
  • Effective management of brucellosis requires strong interdisciplinary collaboration between internal medicine, pathology, and microbiology departments.
  • This case underscores the potential for severe, life-threatening complications in human brucellosis, emphasizing the need for heightened diagnostic vigilance.

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