Brucellosis 2003 proceedings - PHIDIAS

Poster Session
the disease activity. Peripheral-blood PCR assay would have been the highly
sensitive and specific as well as rapid and easy to perform and therefore it would be
considered the most useful tool for diagnosis of brucellosis.
Key words: neurobrucellosis, serodiagnosis, ELISA.
30- CHRONIC COMPLICATIONS OF BRUCELLOSIS: CASE REPORT.
Djordjevic M 1 ., Krstic M. 1 ,Lako B, 2 B.Djukic. Clinic for Infectious Diseases, Clinical Center ,Niš (1),
Military Academy Belgrade (2).
The case report of epidemiological, clinical and serological verified brucellosis
with osteoarticular manifestations like lumbosacral spondilitis and chronic hepatitis
was reported. 33 years old patient with fever of unknown origin and dull pain under
the right costal arch.in duration of one month and a half with positive epidemiological
data was represented. Epidemiological data showed that he consumed row cheese
at the last three months in Kosovo. Diagnosis was confirmed by serological analyses:
BAB +. Wright 1:500. Besides appropriate antibiotic (tetracyclines, rifampicin) and
symptomatic therapy and the initial recovery, after two months of the discharge from
the hospital he complained about back pain, paresthesia of left leg and headache.
Electromyoneurographia and electrostimulation showed proximally lesion L5-S1,
more manifested in radix L5 on the left. Radiography confirmed lumbosacral
spondilitis in level L5-S1. Serological analyses showed BAB +, Wright -. After one
year backpain persisted, hepatic ensimes were elevated, BAB persisted + and
Wright -. After four years of the beginning of the disease, in February 2003, patient
complained again about lumbosacral and neck back pain and dull pain under the
right costal arch.There were elevated levels of hepatic enzymes, biopsy showed
chronic hepatitis, serologicaly both HBs Ag and anti HCV negative. Ultrasound of
liver showed hepatic enlargement and inhomogenous, hypoehogenous liver.
Serological analyses showed BAB- , Wright 1:10 , Elisa: IgM – and IgG +.
Conclusion: lumbosacral spondilitis and chronic hepatitis stayed as a chronic
complications of the brucellosis. It is a reliable evidence that intracellular location of
Brucella protects bacteria from the effects of antibiotics. Also, Brucella organism’s
display many mechanisms to evade the intracellular killing, wich appear to be the
reason for the success of the bacterium in dwelling within macrophages.
Key words: brucellosis, chronic complications, lumbosacral spondilitis, chronic hepatitis.
31- BRUCELLOSIS AND CRIOGLOBULINEMIA.
Hermida I., Sáez L., Solera J. Servicio de Medicina Interna. Hospital General Universitario de
Albacete. Facultad de Medicina, Universidad de Castilla La Mancha. Spain.
A 59-year-old male was admitted for evaluation of a 2-weeks history of
progressive abdominal distension, edema and purpuric rash. He had a history of
heavy smoking and alcohol abuse. His physical exam was significant for ascites,
hepato-splenomegaly, edema and petechiae wich are most prominent on the legs.
Laboratory tests showed an anemia with a haemoglobin level of 9.8 g/dl and
thrombopenia with a platelet level of 51,000/mm 3 , serum creatinine of 1.8 mg/dl,
serum albumin of 2.3 g/dL, increase of GGT and FAL. Low levels of C3 and positive
rheumatoid factor (184 UI/mL), cryoglobulins 1,4% (polyclonal IgG-IgA-IgM).
Brucellosis 2003 International Research Conference
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