Demystifying pyrexia of unknown origin: A case of splenic brucellosis

Abstract

Brucellosis is a zoonotic infectious disease, which mainly involves lymphoreticular system. Our case report describes an isolated splenic lesion diagnosed in a 48-year-old individual who is a farmer by occupation, had a history of animal contact, and has the habit of consuming raw milk. He was admitted as a case of pyrexia of unknown origin (PUO) and detected to have splenic Space occupying lesion (SOL) on imaging. His serum Brucella IgM was positive and ultrasonography-guided fine-needle aspiration cytology of splenic SOL showed features of necrotizing granulomatosis inflammation or an organizing abscess. The patient was successfully treated for brucellosis with oral doxycycline and rifampin for 6 weeks. Hereby, we report a case of PUO with splenic SOLs, Diagnosed on the basis of clinical, radiological, histopathological, and serological basis as a case of spleenic brucellosis. This case required a very high index of clinical suspicion and further highlighted the fact that even in present times of advanced diagnostic modalities, clinical inputs cannot be overlooked. Thereby, we were able to demystify a case of PUO successfully.

Keywords

• brucellosis
• doxycycline
• necrotizing granulomas
• pyrexia of unknown origin
• splenic sol
• zoonosis