Panniculitis as the Initial Manifestation of Brucellosis: A Case Report

Abstract

Here, we describe a 38-year-old male with an abrupt manifestation acute panniculitis as unusual presentation of brucellosis. Brucellosis is a reemerging disease in Turkey, and the disease is primarily transmitted from farm animals to humans. Farmers and shepherds are the major risk groups for brucellosis in Anatolia. Brucellosis may involve almost all systems and organs, including the skin, and may mimic a wide range of illness and syndromes. Although the cutaneous manifestation of brucellosis is not disease specific, but it occurs in about 6%-13% of patients with brucellosis. Some of these lesions including rashes, papules, ulcers, abscess, erythema nodosum, ecchymosed skin rash, purpura, and vasculitis may be seen frequently in brucellosis, but panniculitis is rarely described. The case confirmed by positive blood culture had manifest skin lesion as an initial finding represented by lobular panniculitis with vasculitis.

Brucellosis in India — a review

“…33(4) (Mantur et al 2004a(Mantur et al , 2006. Recently, acute panniculitis as unusual presentation of brucellosis has been reported (Tanyel et al 2008). We have identifi ed in Belgaum, atypical lesions like haemorrhagic epididymo-orchitis, cellulitis, severe anemia, facial palsy with hemiplegia and infertility (table 2).…”

Hypodermite lombaire abcédée révélant une pyonéphrose

“…Rarement, ce tableau peut apparaître dans un contexte de bactériémie sans foyer suppuratif profond sous-jacent [5][6][7][8]. Contrairement à notre cas, le tableau d'hypodermite bactérienne, avec ou sans foyer suppuratif profond sousjacent, est souvent marqué par des signes cliniques importants de sepsis [3,[5][6][7][8] et apparaît parfois dans un contexte d'immunodépression associée, comme lors de tumeurs malignes [3,6]. Les manifestations cutanées des pyonéphroses sont surtout des fistules [9], parfois associées à un abcès sous-cutané [10].…”

Brucellosis presenting as septal panniculitis with vasculitis

“…Massasso and Gibson reported a case of leukocytoclastic vasculitis and brucellosis with deposition of IgA within the walls of dermal vessels 9 . Although the presence of both panniculitis and vasculitis in patients with brucellosis has been described, 8 to our best knowledge this is the first case of brucellosis presenting with septal panniculitis and vasculitis. Tanyel et al.…”

“…Cutaneous vasculitis associated with brucellosis has rarely been reported 8,9 . Massasso and Gibson reported a case of leukocytoclastic vasculitis and brucellosis with deposition of IgA within the walls of dermal vessels 9 .…”

“…Tanyel et al. 8 reported a case of lobular panniculitis and vasculitis as the initial manifestation of brucellosis. They suggested that the lesions may be due to immune complexes and may be the result of a hypersensitivity reaction.…”