Active splenic granuloma as a source of recurrent brucellosis

Williams, Gavin; Hara, Masauki

doi:10.1016/0002-9610(67)90293-0

Cited by 6 publications

(2 citation statements)

References 5 publications

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“…Radiological findings are considered characteristic and showed a hypodense lesion of variable size around or adjacent to a calcium density with a snowflake appearance [29]. Although thinly lamellated calcification and a halo effect have been reported as typical [21,22,24], they were not observed in our patients. Of interest, this hypodensity may not be obvious on noncontrast CT; it may be interpreted as nonactive calcification, thus leading to misdiagnosis, as occurred in 1 of our patients (figure 1).…”

Section: Discussioncontrasting

confidence: 71%

“…Multiple lesions-not always in the same state of reactivation-are detected in ∼20% of patients [11,22,28,30,31]. Tuberculosis and histoplasmosis may be considered in the differential diagnosis [21,24,30,31], but histoplasmosis does not exist in Spain, and no patients with tuberculous hepatic abscess were identified among the 4000 patients with tuberculosis who were prospectively followed in one of our hospitals since 1980 (R. Vidal, Hospital General Vall d'Hebró n, personal communication). Hydatidosis usually presents as calcification, but it can be distinguished by its characteristic thin rim of outer calcification and by the absence of a lamellar or snowflake appearance [29].…”

Section: Discussionmentioning

confidence: 99%

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Current Understanding and Management of Chronic Hepatosplenic Suppurative Brucellosis

Ariza

Pigrau²,

Cañas

et al. 2001

Clinical Infectious Diseases

124

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To outline the characteristics and define appropriate management of chronic hepatosplenic suppurative brucellosis (CHSB), 905 patients with brucellosis were analyzed. Sixteen episodes of CHSB (14 in the liver and 2 in the spleen) were found in 15 patients. Six patients had had previous remote brucellosis. Twelve patients presented with systemic symptoms, and 12 with local symptoms. Cultures of blood samples yielded negative results in all cases except 1, and the results of cultures of pus specimens were positive for Brucella melitensis in only 2 cases. All patients showed calcium deposits surrounded by a hypodense area on computed tomography. Patients often had low titers of agglutinating antibody. In patients who were receiving conservative management, early response was successful in 50% and late response was successful in 33.3%. In the patients who underwent surgery and concomitant antibiotic therapy, early and late response was successful in 100%. Thus, CHSB mainly represents a local reactivation of previous brucellosis. Its diagnosis may be difficult to establish and surgery may be required to cure many patients.

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