Brucella peritonitis and leucocytoclastic vasculitis due to Brucella melitensis

Abstract

Brucellosis is a multisystemic disease that rarely leads to a fatal outcome. While reticuloendothelial system organs are mostly affected, peritonitis and posthepatitic cirrhosis are also complications of brucellosis, though they are very rare. Brucella spp. can also trigger immunological reactions. We report a case of brucellosis with peritonitis, renal failure and leucocytoclastic vasculitis caused by Brucella melitensis, which led to a fatal outcome. Brucellosis should be considered in the differential diagnosis of vasculitic diseases, especially in endemic areas.

The prevalence and impact of brucellosis in patients with hepatitis delta virus infection: inside the Brucella outbreak with cirrhosis

“…Nowadays, there is little information in the English literature regarding the impact of brucellosis in patients with cirrhosis due to HDV infection. Furthermore, there are no published data on the rate of Brucella infection in this unique patient population [ 18 – 20 ]. In the current study, active brucellosis rates were high among CHD-C patients overall (13%), especially in comparison to healthy subjects, but even higher for those with higher MELD scores.…”

A Case of Brucellosis with Recurrent Attacks of Vasculitis

“…Hermida Lazcano et al [11] reported a case of mixed cryoglobulinemia with renal failure, cutaneous vasculitis, and peritonitis due to Brucella melitensis and the authors concluded that all of the clinical picture (renal, hepatic, and cutaneous) was mediated by the cryoglobulins and/or caused by cryoglobulins. Dizbay et al [12] determined hypocomplementemia, increased levels of polyclonal immunoglobulins (IgG, IgA, and IgE), positivity of rheumatoid factor and P-ANCA in the patients with renal failure, and leukocytoclastic vasculitis due to brucellosis and the authors stated that they thought that this picture was caused by mixed cryoglobulinemia. Similarly, also presence of hypocomplementemia, increased levels of polyclonal immunoglobulins, positivity of rheumatoid factor, and recurrent attacks of vasculitis in our case strongly suggest an underlying immunological abnormality.…”

Brucellosis with p-ANCA-associated renal failure, leukocytoclastic vasculitis and endocarditis: Case report

“…Although cutaneous manifestations are not common in Brucellosis, these lesions include extensive purpuric rash (7%) and diffuse maculopapular rash (11%). 2,9,12,14 There are some reports on leukocytoclastic vasculitis in brucellosis. 2,[12][13][14] Cutaneous lesions could be result of direct inoculation, hypersensitivity phenomenon, deposition of immune complexes or direct invasion by the organism.…”

“…2,12,13 Palpable purpura indicates the presence of leukocytoclastic vasculitis related with accumulation of immune complexes. 14 The relationship between brucellosis and p-antinuclear cytoplasmic antibody (p-ANCA)-associated vasculitis (pAAV) is a rare condition. Herein, we reported a case that was diagnosed as rapidly progressive glomerulonephritis (RPGN) and endocarditis due to brucellosis.…”