Abstract:

Brucellosis is a zoonotic infection that is transmitted to humans through the direct contact of fluids of the infected animal or through the consumption of nonpasteurized milk or cheese obtained from the infected animal. In brucellosis, gastrointestinal involvement occurs as clinical hepatitis in 3%[Author1] –6% of cases, and acute hepatitis is a rare condition. A 62-year-old female patient presented to our clinic with complaints of weakness, fever, and yellowing of the sclera. The patient was hospitalized with a preliminary diagnosis of acute cholangitis. At the first admission, the laboratory parameters were white blood cells 9.35 × 109/L, hemoglobin: 11.5 g/dL, platelets: 139 × 109/L, international normalized ratio: 0.95, sedimentation 35 mm, C-reactive protein: 9 mg/dL, albumin 2.5 g/dL, total bilirubin/direct bilirubin 7.4/5.8 mg/dL, aspartate aminotransferase 784 U/L, alanine aminotransferase 418 U/L, alkaline phosphatase 363 U/L, gamma-glutamyl transferase 210 U/L, and lactate dehydrogenase 737 U/L. Abdominal ultrasonography revealed normal findings in the liver, intrahepatic bile ducts, and choledochus. During the clinical follow-up, the patient had insidious fever patterns. Brucella Rose Bengal Lam Agglutination test showed a positive result, and Brucella Coombs Agglutination test also demonstrated a positive result at 1:1280 titer. In addition, brucella was detected in the blood cultures of the patient. Oral doxycycline 100 mg 2 × 1 [Author2] and rifampicin 300 mg 1 × 2 were administered for 6 weeks, after which the patient showed improvement in the clinical and laboratory findings. Therefore, it is recommended to consider brucellosis in the differential diagnosis, especially in patients with fever having acute hepatitis and cholestasis.

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