Brucellosis Presenting with Pericarditis: Case Report and Literature Review

Pericarditis is a rare manifestation during the course of brucellosis. This paper describes a case of pericarditis associated with brucellosis in a 31-year-old veterinary physician with a past medical history of testicular tumor and reviews the cases of pericarditis associated with brucellosis in medical English literature. 1. Introduction Brucellosis is a zoonotic disease caused by Gram-negative bacteria from the genus Brucella. With a worldwide distribution [1, 2], it is considered hyperendemic in South America [3]. More than half a million new cases are diagnosed each year [1], and the prevalence rate exceeds 10 cases per 100,000 inhabitants in some countries [2]. The infection is transmitted to humans by animals, due to occupational exposure or ingestion of contaminated dairy products and meats [1]. With a wide spectrum of clinical manifestations [4], it can affect any organ or tissue in the human body [1]. The most commonly affected systems are the musculoskeletal, gastrointestinal, genitourinary, hematological, and respiratory systems [5]. Acute cases typically present with chills, fever, asthenia, sweating, weight loss, and back pain [5]. The most common findings on physical examination are hepatomegaly and splenomegaly [6]. Cardiovascular complications are rare, [2] with endocarditis being the most common form of cardiovascular system involvement [7]. The purpose of this paper is to report a case of brucellosis that presented with mild pericarditis during its course, not associated with endocarditis or myocarditis. 2. Case Report Male patient, Caucasian, 31 years old, from S？o Martinho da Serra, RS, Brazil. He resides with his wife and his mother. He had a past medical history of testicular tumor at age 24 and was cured after treatment. He had been asymptomatic for five years. On 07/01/2012, he started having fever (40.2°C). He sought medical treatment with the assistant oncologist, who requested additional tests to rule out tumor recurrence. A total abdominal ultrasonography showed hepatosplenomegaly and retroperitoneal lymph node enlargement. A transthoracic echocardiogram showed signs suggestive of acute pericarditis with an asymptomatic patient from the cardiologic point of view. On the 15th day of symptoms, due to clinical and body temperature worsening, he sought the emergency care department of a local hospital, where he was treated by an infectologist. At this point, a detailed clinical history was obtained. He had sustained high fever, above 39°C, which did not improve with antipyretics used for the last five days (dipyrone 4？g/day and