Brucella-induced thyroiditis: A case report

Abstract

A 48-year-old female patient presented to our institution in Lebanon with fatigue of one month duration, fever up to 38.7 ͦC that appears mainly at night, associated with sweating, few episodes of diarrhea, low back pain, and diffuse anterior neck pain. The patient noted she had pasteurized goat cheese 3 weeks prior to her presentation. Physical exam was unremarkable except for cervical anterior pain on palpation. Complete blood counts (CBC) and liver function tests (LFT) were normal, erythrocyte sedimentation rate (ESR) of 45 mm/h, C-reactive protein (CRP) of 85 mg/L, and a brucella rapid agglutination test was positive. TSH was low, Thyroxine (T4) and Triiodothyronine (T3) were both increased with negative thyroid antibodies. A thallium scintigraphy confirmed the diagnosis of subacute thyroiditis. A lumbosacral magnetic resonance imaging (MRI) was normal. The patient was diagnosed with subacute brucella induced thyroiditis and was treated with doxycycline 100 mg every 12 hours and rifampicin 900 mg once a day for a period of 6 weeks. She responded very well with resolution of her clinical symptoms and normalization of her laboratory tests.

Keywords

• Brucella
• Brucellosis
• Zoonotic
• Subacute thyroiditis
• Endocrine system diseases