Cutaneous lesions in brucellosis

Berger, T. G.

doi:10.1001/archderm.117.1.40

Cited by 16 publications

(9 citation statements)

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“…Since the relationship of these skin alterations to brucellosis has remained unclear, while other conditions can lead to similar cutaneous findings, skin lesions have not been considered a characteristic feature of the disease [3]. Apart from the well-defined lesion appearing after direct inoculation of Brucella among veterinarians and animal handlers, only a few isolated reports have been published [4][5][6]. In 1989 Ariza et al, in a review of 436 cases of brucellosis, reported that about 6% of patients had skin lesions probably due to the disease [7].…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous Manifestations in Brucellosis: Case Report and Review of the Literature

Milionis

Christou²,

Elisaf³

2000

Infection

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Brucellosis is a classical common zoonotic disease of worldwide distribution. Skin complications are infrequent and affect less than 5% of patients with brucellosis, although they may occasionally occur during the clinical course of the disease. Here, we report a case of a shepherd presenting with fever and a diffuse maculopapular rash due to Brucella melitensis infection, and we provide a review of the relevant literature.

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Section: Discussionmentioning

confidence: 99%

“…Erythema nodosum (EN) has been previously reported in patients with brucellosis [2,[5][6][7]11]. Berger et al described a patient who exhibited disseminated papular lesions, as well as EN-like deep dermal nodules on the legs, with the same granulomatous findings in both [6].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Manifestations in Brucellosis: Case Report and Review of the Literature

Milionis

Christou²,

Elisaf³

2000

Infection

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“…Thus, vasculitis involving the skin and other organs as well as occasional cases of glomerulonephritis are probably due to deposition of immune complexes rather than the presence of Brucella organisms within these tissues. [7][8][9][10][11][12][13] Involvement of the liver is a frequent complication of human brucellosis. The most commonly described pathology in liver biopsy specimens from patients with brucellosis is nonspecific reactive hepatitis.…”

Section: Discussionmentioning

confidence: 99%

“…A large variety of lesions have been observed. [7][8][9][10] These may be macular, maculopapular, vesicular, purpuric, and psoriatic. The corresponding histologic appearances have not been fully elucidated.…”

Section: Discussionmentioning

confidence: 99%

Pathology of Brucellosis: A Review of 88 Biopsies

Akhtar

Ali

1989

Ann Saudi Med

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“…Special stains may demonstrate the organism in the latter lesion. 8 Noncaseating granulomas 9 and granulomatous vasculitis 10 have also been described.…”

Section: Discussionmentioning

confidence: 99%

Skin Lesions in Brucellosis: Report of Two Cases

et al. 1988

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Brucellosis is an endemic disease in many parts of the world. It is a generalized infection with many systemic manifestations, but skin involvement is unusual. 1 We describe two patients with skin lesions associated with brucellosis who also demonstrate the diagnostic problems that such uncommon manifestations may pose. Case Reports Case 1A 17-year-old Saudi female had a one-month history of fever, chills, and rigors, and a history of painful swelling of both knees of one week's duration. She admitted to drinking raw goat milk frequently. On examination, she looked ill, with a temperature of 39.6°C. The skin showed an erythematous maculopapular rash in a butterfly distribution on the face and a punctate erythematous rash on all four extremities. There was hepatosplenomegaly, bilateral knee effusion, and pitting edema of both feet and ankles. She had mild proteinuria (400 mg/24 hours).Initially, a diagnosis of systemic lupus erythematosus (SLE) was considered. Serologic tests for SLE were negative. Brucella melitensis was grown from her blood; the brucella agglutination test was positive in a titer of 1:80 increasing to 1:320 over one week. She made a complete recovery after a three-week course of streptomycin and 12 weeks of doxycycline. The skin lesions disappeared after two weeks of therapy. Case 2A 40-year-old Saudi woman had a two-month history of malaise, fever, arthralgia, headache, and weight loss. More recently, she had lower abdominal pain and diarrhea with blood.On examination she looked ill, and her temperature was 39°C. Her liver was enlarged and tender, and her spleen was enlarged. She had an erythematous maculopapular rash over the trunk and limbs (Figure 1). The lesions were discrete and had no relation to hair follicles. There was no pruritus. The rash did not involve the face, scalp, palms, soles, or nails. Initial investigation revealed WBC count of 4,000/mm 3 , hemoglobin of 10.8 g with normal indices, and erythrocytic sedimentation rate of 30 mm/hr. Liver function tests yielded mildly abnormal results. Biopsy from one of the lesions (Figure 2) showed mild hyperkeratosis and focal chronic inflammatory infiltrate in the dermis, consisting mainly of lymphocytes and monocytes with occasional plasma and epithelioid cells. The infiltrate was partly perivascular and periadnexal. There were no granulomas. Serology for brucella was positive with a titer of 1:320 for both B. abortus and B. melitensis. Widal test was negative. Blood culture grew brucella species. She was diagnosed as having brucellosis and treated with rifampicin for four weeks and co-trimoxazole for eight weeks. She responded well. The rash disappeared two weeks after treatment started.

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Cutaneous lesions in brucellosis

Cited by 16 publications

References 0 publications

Cutaneous Manifestations in Brucellosis: Case Report and Review of the Literature

Cutaneous Manifestations in Brucellosis: Case Report and Review of the Literature

Pathology of Brucellosis: A Review of 88 Biopsies

Skin Lesions in Brucellosis: Report of Two Cases

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