Brucellosis in the Head and Neck: A Forgotten Differential Diagnosis

Abstract

INTRODUCTION: Patients with brucellosis present with nonspecific symptoms originating from different organs. In this study, we aimed to investigate the symptoms related to the head and neck region in patients with brucellosis. METHODS: The retrospective study analyzed 542 patients with a definitive diagnosis of brucellosis who were admitted to our hospital between January 2015 and April 2022 and received outpatient and/or inpatient care. Clinical symptoms localized to the ear-nose-throat and head and neck regions were evaluated. RESULTS: A neck mass was detected in 52 out of 542 patients included in the study. The prevalence of cervical lymphadenopathy and/or abscess was 9.6%. Only lymphadenopathy was present in 30 (57.7%) patients, while both neck abscess and lymphadenopathy were detected in 22 (42.3%) patients. No significant difference was found between the two groups with regard to treatment regimens (p=0.37). Mean duration of treatment was 30 +- 22.1 (range, 14-70) days in the lymphadenopathy group and was 22 +- 14.7 (range, 14-60) days in the abscess group. No significant difference was found between the two groups with regard to the length of time to clinical recovery (p=0.34). DISCUSSION AND CONCLUSION: Brucellosis affects many regions of the head and neck and can have a variety of imaging manifestations that mimic benign and malignant lesions. The diagnosis of brucellosis should be considered in the first-line differential diagnosis conducted based on imaging features in patients residing in endemic regions.

Keywords

• brucella
• head and neck
• abscess
• lymphadenopathy
• granulomatous infection.