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Cholecystitis Related to Brucella melitensis: A Rare Presentation

Gunal, Esen Kasapoglu MD; Topkaya, Aynur Eren MD; Arisoy, Ayse MD; Aydiner, Omer MD; Gökçen, Gökhan MD; Aksungar, Fehime Benli MD; Karabulut, Murat MD; Tulbek, M. Yasar MD; Aytug, O. Necip MD

Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e318146896b
Case Reports
Abstract

Although human brucellosis is a multisystemic disease, cholecystitis due to Brucella species is a rare manifestation. Here we present a 64-year-old woman with Brucella cholecystitis who was admitted to the hospital with fever and arthralgias for the last 10 days. Her complete blood count and blood chemistry were unremarkable other than C-reactive protein: 3.08 mg/dL (<0.5 mg/dL), aspartate transaminase: 70 U/L (<65 U/L), alanine transaminase: 71 U/L (<37 U/L), γ-glutamyl transferase: 748 U/L (<85 U/L), and alkaline phosphatase: 285 U/L (<136 U/L). On the second day of hospitalization, she complained of diffuse abdominal pain, and physical examination revealed Murphy sign. Abdominal ultrasonography was consistent with acute cholecystitis. She was given ciprofloxacin because she refused cholecystectomy. On the 10th day of admission, she still had fevers, and Brucella melitensis was recovered from blood culture specimens. Brucella agglutination tests were also found to be positive. She was symptom free after the fifth day of introduction of streptomycin, doxycycline, and rifampicin.

Author Information

Division of Rheumatology, Department of Internal Medicine, Maltepe University Medical Faculty, Maltepe, Istanbul, Turkey.

Address correspondence and reprint requests to Esen Kasapoglu Gunal, MD, Division of Rheumatology, Department of Internal Medicine, Maltepe University Medical Faculty, Maltepe, Istanbul, 34843 Turkey. E-mail: kasapogluesen@yahoo.com

© 2008 Lippincott Williams & Wilkins, Inc.