title: Liver histology of acute brucellosis caused by Brucella melitensis.
abstract: As a major organ of the mononuclear phagocytic system, the liver is probably involved in all cases of brucellosis. In this prospective study, liver slides prepared from percutaneous liver biopsy samples of 20 patients with clinical and laboratory evidence of acute brucellosis due to Brucella melitensis were examined for the presence or absence of granulomas by pathologists in Iran and the United States. Nineteen men and one woman ranging in age from 14 to 62 years were studied. All patients had clinical signs and symptoms compatible with acute brucellosis, and all had significantly elevated titers of antibodies to Brucella in their serum. Liver function tests were mildly elevated in 11 (55%) cases, and C-reactive protein was positive in 15 (65%) patients. Thirteen (65%) patients had blood cultures positive for B melitensis. Iranian and American pathologists reported granulomas in 3 (15%) and in 4 (20%) cases, respectively. There was agreement between Iranian and American pathologists in 17 (85%) cases. The most prevalent findings were mild portal or lobular lymphocytic inflammation (16 cases). Two cases revealed noncaseating epithelioid granulomas, and 2 had microgranulomas. The results show that all patients had microscopic evidence of liver involvement. The predominant histologic finding was mild portal or lobular inflammation with lymphocytes. Granulomas were present in only 4 cases.
authors.affiliation: Section of Infectious Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, 77030, USA; Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Young
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Babol Medical University, Babol, 4717641367, Iran. Electronic address: hagar2q@yahoo.ca.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Hasanjani Roushan
authors.affiliation: Department of Pathology and Laboratory Medicine, Rohani Teaching Hospital, Babol Medical University, Babol, 4717641367, Iran.
authors.forename: Shariar
authors.initials: S
authors.lastname: Shafae
authors.affiliation: Department of Pathology, Southwestern Medical School, Dallas, Irving, TX, 75039, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Genta
authors.affiliation: Department of Pathology, Southwestern Medical School, Dallas, Irving, TX, 75039, USA.
authors.forename: Shari L
authors.initials: SL
authors.lastname: Taylor
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017347:Brucella melitensis; D002006:Brucellosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000382:microbiology / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Brucella melitensis; Granuloma; Iran; Liver; Pathology