Paravertebral abscess formation and knee arthritis due to Brucellosis in a patient with rheumatoid arthritis

Point of View

“…ages, the viable cyst wall appears isointense or slightly hypointense than the cyst content and enhances after contrast medium injection. 29,30 As in our case, first clinical and radiographic appearance resembles a space-occupying, expansive, and destructive tumor-like lesion. 8,9,19 -21 Moreover, a recently published study suggested that proton MR spectroscopy may be helpful in separating hydatid cysts from cysticercus cyst according to the metabolite patterns of the fluid of these two parasitic cysts.…”

Infliximab and brucellosis: not the usual suspects, this time

“…Indeed, brucellosis in a patient with RA who has been treated with immunosuppressant agents may cause serious multiorgan involvement [8]. Rheumatoid joints are more prone to infections, and drugs used for the treatment of RA may alter the host defense and/or may mask brucella symptoms, resulting a delayed diagnosis and more severe disease course [8]. There are particular problems with the differential diagnosis or flares of spondyloarthropathies and brucellosis [9].…”

“…We suggest that endemic organisms such as brucella should be in the check list when an infection is suspected during anti-TNF treatment. Indeed, brucellosis in a patient with RA who has been treated with immunosuppressant agents may cause serious multiorgan involvement [8]. Rheumatoid joints are more prone to infections, and drugs used for the treatment of RA may alter the host defense and/or may mask brucella symptoms, resulting a delayed diagnosis and more severe disease course [8].…”

A case of brucellar monoarthritis and review of the literature

“…Steroidal and non-steroidal anti-inXammatory drugs have the potential to mask disease manifestations. Therefore, in endemic areas, it is important to be aware of the possibility of brucellosis in patients with rheumatoid arthritis [7].…”