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Case Report: Brucella melitensis infection with pulmonary and spinal complications

CR6 (35) - Kim - brucella
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Project Title: Case Report: Brucella melitensis infection with pulmonary and spinal complications. Authors: Eric Kim, MD; Alexandra Targan, MD; Stephanie Eldred, MD; Daniel White, MD

Program: University of Colorado Family Medicine Residency

Abstract: Our patient was a 65 year old man who was sent to our hospital complaining of back pain and weight loss to rule-out tuberculosis. He had recently traveled to the US from Mexico. Despite a positive QuantiFERON, lung imaging suggestive of focal consolidations, and spinal imaging showing an epidural phlegmon, initial workup ruled out tuberculosis. Further history revealed that he was previously a butcher and had in the past year started drinking unpasteurized goat’s milk. Culture of the epidural phlegmon eventually resulted brucella melitensis. Brucella is a zoonotic disease with significant livestock reservoirs still endemic to certain parts of the world. It is a highly contagious disease with multi-organ manifestations. Despite brucellosis’s eradication in the US, this case serves as a cautionary tale to avoid anchoring bias, keep infectious differentials broad, and always ask about exposures.

Learning Objectives: Participants will be able to… • describe the circumstances under which brucella infection should be considered. • describe the possible manifestations of brucellosis. • describe the possible morbidity associated with brucellosis.

Category: Case report

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