Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3649
Peer-review started: October 25, 2020
First decision: January 17, 2021
Revised: January 27, 2021
Accepted: March 15, 2021
Article in press: March 15, 2021
Published online: May 26, 2021
Processing time: 197 Days and 22.7 Hours
Brucellosis is a contagious bacterial disease caused by Brucella species, which is a leading zoonotic disease worldwide. Most patients with brucellosis have a clear infection source; however, our case had a rare presentation of secondary haemophagocytic lymphohistiocytosis without any epidemiological history.
A 50-year-old man was admitted to our hospital with a fever of unknown origin. After laboratory examinations, such as blood culture and bone marrow biopsy, the patient was diagnosed with brucellosis and secondary haemophagocytic lymphohistiocytosis. After antibiotic therapy, the patient was afebrile, and his haemogram recovered to normal, after which he was discharged.
Brucellosis cannot be excluded in patients with clinically unexplained fever, even in those without epidemiologic history.
Core Tip: Most patients of brucellosis present with a clear infection source. However, our patient showed a rare case presentation of haemophagocytic lymphohistiocytosis with no clear infection source and unremarkable medical history. Our findings suggest that brucellosis cannot be excluded in patients with clinically unexplained fever, even in those without epidemiologic history. To prevent timely exacerbation of the disease, before obtaining the aetiology test results, the administered antibiotics should cover rare pathogens, such as Brucella.