Mucosal Brucella Infection in Human: A Case Study

Abstract

Brucellosis in human is an uncommon disease in Libya and usually diagnosed by serological assays. The clinical symptoms of this disease are none specific which makes differential diagnosis difficult.The patient was a sixteen years old girl, lives in a rural area. She was suffering from intermittent fever for several days associated with chills, mild cough, and headache. Comprehensive physical examination revealed the patient was generally unwell, pallor and, had abdominal tenderness. Laboratory investigations revealed that the patient had pancytopenia and a marked increase in C-reactive protein, procalcitonin, lactate dehydrogenase, aspartate transaminase. Provisional diagnosis was acute leukemia or aplastic anemia. Slow growth of Gram-negative coccobacilli in aerobic blood culture was detected. It could not clearly be identified by phoenix bacterial identification system. It was provisionally misdiagnosed Haemophilus spp; while finally it was identified Brucella spp. Brucellosis may manifest in a delicate manner which makes its diagnosis very challenging. It has the ability to affect various systems in the body, displaying a confusion in differential diagnosis, and delay in medical care, thus raising the risk of complications. Unusual medical laboratory findings should not be overlooked as they could help in bringing up the right clinical diagnosis.