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BMJ Case Reports 2011; doi:10.1136/bcr.12.2010.3586
  • Unusual presentation of more common disease/injury

Brucellosis presenting as septic shock

  1. Sidney Tessler1
  1. 1Division of Pulmonary & Critical Care Medicine, Maimonides Medical Center, Medicine, Brooklyn, New York, USA
  2. 2Department of Internal Medicine, Maimonides Medical Center, Brooklyn, New York, USA
  1. Correspondence to Dr Sidney Tessler, stessler{at}maimonidesmed.org

Summary

Brucellosis generally presents with fever, malaise, weight loss and bone pain with either an abrupt or insidious onset. A 76-year-old man presented in April 2010 with fever of 103°F, severe tachycardia, tachypnoea and a blood pressure of 80/50 mm Hg requiring fluids and vasopressor support with norepinephrine. The patient had brucellosis in 1956 which was treated for ‘many weeks’ with tetracycline and streptomycin. He has had no recurrences since that time. He denies recent travel outside the USA or consumption of raw dairy products. Blood cultures grew Brucella melitensis. He was treated with gentamycin, doxycycline and rifampin for 1 week and discharged home on doxycycline and rifampin. He relapsed after 2 days, requiring re-admission and a 4-week course of gentamycin. This case is most unusual in that the brucellosis presented with septic shock after a 50-year quiescence and required prolonged therapy with gentamycin to induce remission.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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