title: Spontaneous bacterial peritonitis: an unusual manifestation of brucellosis in a previous healthy male patient.
abstract: Brucellosis is a common zoonotic disease with worldwide distribution and protean clinical manifestations. Therefore, its prompt and timely diagnosis is still challenging. Among several complications of brucellosis, spontaneous bacterial peritonitis (SBP) in previously healthy participants is rarely recognised, although this condition can be fatal if misdiagnosed and untreated. We present a case of a 69-year-old previously healthy stockbreeder who suffered from back pain along with abdominal pain and distension because of ascites of 6-8 weeks duration. Cultures of ascitic fluid and peripheral blood specimens revealed Brucella spp as the causative agent of ascites and spondylodiscitis, which was then confirmed by MRI findings. After appropriate treatment for 4.5 months (streptomycin 1 g/day for 3 weeks intramuscularly, doxycycline 100 mg twice a day orally and rifampicin 900 mg/day orally), the patient fully recovered. Conclusively, in the appropriate epidemiological and clinical setting, the consideration of brucellosis in the differential diagnosis of SBP could be rational as well as life-saving.
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Makaritsis
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Liaskos
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Papadamou
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece.
authors.forename: George N
authors.initials: GN
authors.lastname: Dalekos
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000382:microbiology*; D000368:Aged; D000822:Animal Husbandry; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001201:Ascites / Q000209:etiology / Q000382:microbiology*; D001416:Back Pain / Q000209:etiology / Q000382:microbiology*; D002002:Brucella / Q000302:isolation & purification*; D002006:Brucellosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D004318:Doxycycline / Q000008:administration & dosage; D006801:Humans; D008297:Male; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D012293:Rifampin / Q000008:administration & dosage; D013307:Streptomycin / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline; D012293:Rifampin; D013307:Streptomycin