An unusual presentation of acute brucellosis with fever, jaundice and maculopapular rash. of the International Society for Infectious Diseases

摘要

The clinical features of brucellosis are diverse. An uncommon case of brucellosis with the triple conditions of fever, jaundice and maculopapular rash is described.A 35-year-old male farmer was admitted to our clinic because of a seven-day history of fever, jaundice, generalized myalgia, fatigue, vomiting, anorexia, sweating and a maculopapular rash that had appeared one day before admission. The rash covered the trunk, arms and legs. Physical examination revealed fever of 39deg C, tachycardia of 110/min, and blood pressure of 110/90 mmHg. He had jaundice, rash and hepatosplenomegaly. Laboratory findings were: white cell count: 6.2 x 10~9/L, hematocrit: 37%, platelet count: 45 x 10~9/L, erythrocyte sedimentation rate: 8 mm/h, and C-reactive protein: 7.4 mg/dL (0-0.5 mg/dL).Biochemical parameters were BUN: 27 mg/dL (5-23 mg/dL), creatinine: 1.7 mg/dL (0.8-1.4 mg/dL), total bilirubin: 5.9 mg/dL (0.25-1.2 mg/dL), direct bilirubin: 2.8 mg/dL (0-0.2 mg/dL), alkaline phosphatase: 502 U/L (64-300 U/L), AST: 486 U/L (10-37 U/L), ALT: 363 U/L (10-37 U/L), and LDH: 3320 U/L (220-450 U/L).