Tian LH, Dong ZG, Chen XY, Huang LJ, Xiao PP. Brucellosis of unknown origin with haemophagocytic syndrome: A case report. World J Clin Cases 2021; 9(15): 3649-3654 [PMID: 34046465 DOI: 10.12998/wjcc.v9.i15.3649]
Corresponding Author of This Article
Ping-Ping Xiao, MD, Associate Chief Physician, Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, No. 566 Shengguang Road, Jimei District, Xiamen 361021, Fujian Province, China. xiaopp0026@163.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Li-Hong Tian, Zhi-Gao Dong, Xu-Yan Chen, Ping-Ping Xiao, Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
Lian-Jiang Huang, Department of Laboratory, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
Author contributions: Tian LH and Xiao PP contributed equally; Dong ZG and Chen XY managed the patient in the hospital; Tian LH collected the patient’s clinical data; Huang LJ collected the laboratory data; Xiao PP drafted and revised the manuscript; All authors approved the final manuscript.
Supported byXiamen Medical and Health Guidance Project, No. 3502Z20199137.
Informed consent statement: Written informed consent was obtained from the patient for the inclusion of his clinical details for publication.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ping-Ping Xiao, MD, Associate Chief Physician, Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, No. 566 Shengguang Road, Jimei District, Xiamen 361021, Fujian Province, China. xiaopp0026@163.com
Received: October 25, 2020 Peer-review started: October 25, 2020 First decision: January 17, 2021 Revised: January 27, 2021 Accepted: March 15, 2021 Article in press: March 15, 2021 Published online: May 26, 2021 Processing time: 197 Days and 22.7 Hours
Abstract
BACKGROUND
Brucellosis is a contagious bacterial disease caused by Brucella species, which is a leading zoonotic disease worldwide. Most patients with brucellosis have a clear infection source; however, our case had a rare presentation of secondary haemophagocytic lymphohistiocytosis without any epidemiological history.
CASE SUMMARY
A 50-year-old man was admitted to our hospital with a fever of unknown origin. After laboratory examinations, such as blood culture and bone marrow biopsy, the patient was diagnosed with brucellosis and secondary haemophagocytic lymphohistiocytosis. After antibiotic therapy, the patient was afebrile, and his haemogram recovered to normal, after which he was discharged.
CONCLUSION
Brucellosis cannot be excluded in patients with clinically unexplained fever, even in those without epidemiologic history.
Core Tip: Most patients of brucellosis present with a clear infection source. However, our patient showed a rare case presentation of haemophagocytic lymphohistiocytosis with no clear infection source and unremarkable medical history. Our findings suggest that brucellosis cannot be excluded in patients with clinically unexplained fever, even in those without epidemiologic history. To prevent timely exacerbation of the disease, before obtaining the aetiology test results, the administered antibiotics should cover rare pathogens, such as Brucella.
