Journal Article

Current Understanding and Management of Chronic Hepatosplenic Suppurative Brucellosis

J. Ariza, C. Pigrau, C. Cañas, A. Marrón, F. Martínez, B. Almirante, J. M. Corredoira, A. Casanova, J. Fabregat and A. Pahissa

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 7, pages 1024-1033
Published in print April 2001 | ISSN: 1058-4838
Published online April 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/319608
Current Understanding and Management of Chronic Hepatosplenic Suppurative Brucellosis

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To outline the characteristics and define appropriate management of chronic hepatosplenic suppurative brucellosis (CHSB), 905 patients with brucellosis were analyzed. Sixteen episodes of CHSB (14 in the liver and 2 in the spleen) were found in 15 patients. Six patients had had previous remote brucellosis. Twelve patients presented with systemic symptoms, and 12 with local symptoms. Cultures of blood samples yielded negative results in all cases except 1, and the results of cultures of pus specimens were positive for Brucella melitensis in only 2 cases. All patients showed calcium deposits surrounded by a hypodense area on computed tomography. Patients often had low titers of agglutinating antibody. In patients who were receiving conservative management, early response was successful in 50% and late response was successful in 33.3%. In the patients who underwent surgery and concomitant antibiotic therapy, early and late response was successful in 100%. Thus, CHSB mainly represents a local reactivation of previous brucellosis. Its diagnosis may be difficult to establish and surgery may be required to cure many patients.

Journal Article.  5718 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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