Abstract

Brucellosis, which has dramatically decreased in France, remains a public health problem in Mediterranean countries. We report the case of a 59-year-old man who presented with isolated fever one month after returning from Italy. He related the consumption of local products in Sicily. Laboratory tests showed inflammation, thrombocytopenia, and cytolysis. The agglutination test for Brucella was positive. Serology forYersinia was negative. The patient was given a one-month course of tetracycline with improvement. One month later, he presented again with fever. On heart auscultation, a systolic murmur was noted. Laboratory findings showed platelets 158.10⁹/L, sedimentation rate 17 mm/h, C-reactive protein 54 mg/dL, (normal range < 10 mg/dL), and cytolysis 2 (5 × normal range). Echocardiography showed aortic valve vegetation. A blood culture was positive for Brucella melitensis. The patient was prescribed ceftriaxone for four weeks, doxycycline and rifampicin for seven weeks, and made an uneventful recovery. His 50-year-old wife also presented with fever four months after their return. She, too had consumed local products in Sicily, but had a negative brucellosis serology when her husband's agglutination test revealed a positive finding. At this time, however, although the examination was normal, laboratory tests indicated inflammation and thrombocytopenia, and a blood culture identified B melitensis. Cardiac echocardiography was normal. She responded well to a one month course of cyclin.