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Inicio Revista Colombiana de Reumatología (English Edition) Brucellosis and sacroiliitis: A differential diagnosis to keep in mind
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Case report
Brucellosis and sacroiliitis: A differential diagnosis to keep in mind
Sacroiliitis por brucelosis: Un diagnóstico diferencial para tener presente
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2049
Omar Fernando Bolaños Toroa,b, Lina María Saldarriaga Riveraa,c,
Corresponding author
vasculitisreumato@gmail.com

Corresponding author.
, Edna Juliana Murcia Rojasa,d, Julián Andrés Hoyos Pulgarina,b
a Research Group in Internal Medicine, Faculty of Medicine, Technological University of Pereira, Pereira, Colombia
b Department of Internal Medicine, Faculty of Health Sciences, Technological University of Pereira, Pereira, Colombia
c Department of Internal Medicine, Rheumatology Unit, Faculty of Health Sciences, Technological University of Pereira, Pereira, Colombia
d Medicine Programme, Faculty of Health Sciences, Technological University of Pereira, Pereira, Colombia
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Received 11 April 2020. Accepted 23 June 2020
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Table 1. Description of the laboratory studies performed to the patient.
Table 2. Description of the hemogram during hospitalization.
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Abstract

Brucellosis is a zoonosis that causes a multi-organ granulomatous infection. It has diverse and non-specific clinic features that can make diagnosis difficult. Medical personnel often do not recognize it early. Delayed treatment is associated with high morbidity and even mortality. Its timely diagnosis requires a high index of suspicion. The case is presented of a 35-year-old male zootechnologist, previously healthy, with a progressive picture of two months of evolution of irradiated low back pain to the left hip, nocturnal diaphoresis, and unintentional weight loss. Elevation of acute phase reactants was documented and magnetic resonance imaging found signs of iliopsoas tendonitis and inflammatory changes in the left sacroiliac joint. The IgG and IgM antibodies using an immunoassay for brucella were positive. After establishing antibiotic treatment, a marked clinical improvement, with resolution of the inflammatory process was evident.

Keywords:
Brucellosis
Bovine
Sacroiliitis
Low back pain
Spondylitis
Resumen

La brucelosis es una zoonosis que genera una infección granulomatosa multiorgánica. Tiene una clínica diversa e inespecífica que puede hacer difícil el diagnóstico. Con frecuencia, el personal médico no la reconoce de forma temprana. El retraso en el tratamiento se asocia a una gran morbilidad e incluso mortalidad. Su diagnóstico oportuno requiere un alto índice de sospecha. Se presenta el caso de un hombre de 35 años, zootecnista, previamente sano, con un cuadro progresivo de dos meses de evolución de dolor lumbar irradiado a cadera izquierda, diaforesis nocturna y pérdida no intencional de peso. Se documentó elevación de reactantes de fase aguda y en la resonancia magnética se encontraron signos de tendinitis del psoas y cambios inflamatorios en la articulación sacroilíaca izquierda. Los anticuerpos IgG e IgM por inmuno ensayo para brucella fueron positivos, y luego de instaurar tratamiento antibiótico se evidenció marcada mejoría clínica con resolución del proceso inflamatorio.

Palabras clave:
Brucelosis
Bovino
Sacroiliitis
Dolor lumbar
Espondilitis

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