Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2021; 9(21): 6009-6016
Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.6009
Rare case of brucellosis misdiagnosed as prostate carcinoma with lumbar vertebra metastasis: A case report
Jun-Feng Yan, Hai-Yong Zhou, Sheng-Fu Luo, Xing Wang, Jian-Di Yu
Jun-Feng Yan, Hai-Yong Zhou, Sheng-Fu Luo, Xing Wang, Jian-Di Yu, Department of Urology, Zhejiang Hospital, Hangzhou 310030, Zhejiang Province, China
Author contributions: Yan JF and Luo SF reviewed the literature and contributed to manuscript drafting; Zhou HY and Wang X collected the patient’s clinical data; Yu JD was responsible for the revision of the manuscript; All authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict 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:
Corresponding author: Jian-Di Yu, PhD, Doctor, Department of Urology, Zhejiang Hospital, No. 1229 Gudun Road, Hangzhou 310030, Zhejiang Province, China.
Received: February 3, 2021
Peer-review started: February 3, 2021
First decision: April 25, 2021
Revised: May 6, 2021
Accepted: May 27, 2021
Article in press: May 27, 2021
Published online: July 26, 2021

Prostatitis caused by Brucella infection is rare and usually lacks typical lower urinary tract symptoms. However, Brucella infection can cause serum prostate-specific antigen levels to become abnormally elevated. When concurrent with lumbar vertebra infection and erosion, brucellosis can easily be misdiagnosed as prostate cancer with bone metastasis.


A 45-year-old man complained of recurrent low back pain and fever for 2 wk. Magnetic resonance imaging of the lumbar vertebrae showed abnormal signs at the rear of the L4–5 vertebral body. Serum prostate-specific antigen level was 17.64 ng/mL, and positron emission tomography/computed tomography suggested the possibility of prostate cancer with liver and lumbar metastases. The patient was transferred to our department for further treatment. He experienced repeated bouts of fever and low back pain during hospitalization. Biopsy results indicated prostatitis. There was no significant increase in white blood cell count or procalcitonin levels. The Mycobacterium tuberculosis smear and antibody detection results were negative. Cefoperazone sulbactam was not effective. Blood culture test results were positive for brucellosis, confirming the diagnosis of brucellosis. After oral anti-infection treatment with doxycycline and rifampicin, the body temperature gradually returned to normal, and lumbago improved. After continuous treatment for 6 mo, the patient recovered.


In patients with low back pain and fever accompanied by elevated prostate-specific antigen levels and lesions of the prostate and lumbar spine, a detailed medical history and blood and urine cultures should be obtained, and attention should be given to the local epidemic infectious disease situation.

Keywords: Brucellosis, Prostatitis, Infectious disease, Fever, Prostate-specific antigen, Case report

Core Tip: Brucella infection of both the prostate and lumbar spine is rare. We present a case of such an atypical presentation accompanied by fever and low back pain. Abnormally elevated serum prostate-specific antigen levels and abnormally high metabolic signals in the prostate and lumbar spine were indicated on positron emission tomography/computed tomography scans, which were suggestive of a diagnosis of prostate cancer with lumbar metastases, except for the unexplained periodic fever. Blood culture and agglutination tests were used to confirm brucellosis. This case highlights the need to pay more attention to and identify the atypical symptoms caused by Brucella infection.