Brucellosis,a diagnostic dilemma,presenting atypically in a child with terminal ileitis:A case report  

Brucellosis,a diagnostic dilemma,presenting atypically in a child with terminal ileitis:A case

作　　者：Kokila Banerjee Amitava Pahari Subhendu Roy 

机构地区：[1]Department of Microbiology,Drs.Tribedi and Roy Diagnostic Laboratory,Kolkata 700016,West Bengal,India [2]Department of Pediatric Infectious Diseases,Apollo Hospitals,Kolkata,kolkata 700048,India [3]Drs.Tribedi and Roy Diagnostic Laboratory,Kolkata,Kolkata 700012,India

出　　处：《World Journal of Clinical Infectious Diseases》2023年第3期24-30,共7页世界临床传染病学杂志

摘　　要：BACKGROUND Brucellosis is endemic in India with seropositivity rates as high as 10%in children in the eastern states,yet the disease is not on the radar when a differential diagnosis of pyrexia of unknown origin(PUO)is being considered,especially in children in urban set-up.This may be because of the non-specific multitude of systemic symptoms seen in this disease and the lack of awareness among clinicians.CASE SUMMARY We present a case of a 13-year-old boy,who came with a history of undulating fever for the past three and a half months,loss of appetite,and abdominal pain.The child had visited several pediatricians and was even admitted to a tertiary care hospital for PUO evaluation,but to no avail.He presented to us after three and half months of suffering and weight loss of more than 10%of body weight.His ultrasonography revealed thickening of the terminal ileum.His blood culture grew Brucella melitensis.A diagnosis of Brucellosis with terminal ileitis was made.Brucella serology by enzyme-linked immunoassay(ELISA)was positive for both IgG and IgM.He was treated with doxycycline and Rifampicin along with syrup multivitamin and zinc,for 6 wk.There was remarkable improvement with gain in 4 kg body weight within 2 mo of completing treatment.History revealed consumption of unpasteurized milk and contact with cattle.CONCLUSION Clinical suspicion,detailed history,appropriate laboratory investigations are the three pillars for diagnosing Brucellosis in patients presenting with vague symptoms.

关 键 词：Pyrexia of unknown origin Terminal ileitis BRUCELLOSIS Case report 

分 类 号：R51[医药卫生—内科学]