title: Brucellosis: the first case of King Chulalongkorn Memorial Hospital and review of the literature.
abstract: Brucellosis remains a major zoonotic disease worldwide. It has never been reported at King Chulalongkorn Memorial Hospital (KCMH). The authors describe the first case of brucellosis in KCMH, and also review all previous reports in Thailand. The presented case was a 52-year-old Thai man, living in Phetchabun Province, who was diagnosed with idiopathic pulmonary fibrosis two years prior to admission. He presented with prolonged fever, dry cough, weight loss of eight kg over three months, hepatosplenomegaly, and pancytopenia. Blood and bone marrow cultures grew Brucella melitensis at 72 hours of incubation. A slide agglutination (Rose Bengal) test was also positive for Brucella antibody. He had been exposed to contaminated placenta of his goats that had spontaneous abortion in the past few months before his illness. The patient was successfully treated with gentamicin, doxycycline, and rifampicin. Clinicians should have a high index of suspicion when evaluating patients presenting with prolonged fever and having an exposure risk of brucellosis.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Leilani
authors.initials: L
authors.lastname: Paitoonpong
authors.forename: Monaya
authors.initials: M
authors.lastname: Ekgatat
authors.forename: Pongpun
authors.initials: P
authors.lastname: Nunthapisud
authors.forename: Terapong
authors.initials: T
authors.lastname: Tantawichien
authors.forename: Chusana
authors.initials: C
authors.lastname: Suankratay
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017347:Brucella melitensis / Q000302:isolation & purification*; D002006:Brucellosis / Q000175:diagnosis*; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005334:Fever; D005456:Fluorescent Dyes; D005839:Gentamicins / Q000627:therapeutic use; D006041:Goats; D006761:Hospitals; D006801:Humans; D008091:Literature; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use; D012395:Rose Bengal; D013785:Thailand
chemical_list: D000900:Anti-Bacterial Agents; D004791:Enzyme Inhibitors; D005456:Fluorescent Dyes; D005839:Gentamicins; D012395:Rose Bengal; D004318:Doxycycline; D012293:Rifampin