Coexistence of pancreatic tuberculosis with systemic brucellosis: a case report

• Authors: Ali Acar , İlker Sücüllü , Orhan Baylan , Ali Filiz , Hüsrev Diktaş , Mert Kıvanc , Oral Öncül , Levent Görenek
• Languages of publication: EN

Abstracts

EN

Isolated pancreatic tuberculosis is an extremely rare clinical entity and is difficult to diagnose particularly in immunocompetent individuals. Clinical findings and symptomatology of brucellosis are often similar to tuberculosis thus making the differentiation amongst the two entities difficult. We report a case of pancreatic tuberculosis with systemic brucellosis in a 29 year old veterinarian who presented with epigastric pain and loss of appetite. Initial investigations revealed leukocytosis with moderately elevated transaminase, gamma glutamyl transferase, amylase and lipase levels. Imaging studies revealed an anechoic multiloculated cyst in the body and tail of the pancreas. Given the patient’s occupational risk coupled with the presence of a positive Brucella agglutination test (with a titer of 1:320); a diagnosis of pancreatitis secondary to brucellosis was given. In addition to standard pancreatitis therapy of bowel rest with intravenous fluid/electrolyte replacement, anti-brucellosis therapy was also administered. The patient’s initial response to therapy was positive however, 6 weeks into therapy, his abdominal pain recurred and repeat CT scan revealed the development of a pseudocyst in the pancreas. After failing a second attempt at conservative supportive therapy, the patient underwent an explorative laparotomy. Histological examination of the resected pancreatic specimen showed necrosis and was positive for tuberculosis by polymerase chain reaction. Herein, we describe the first case reported in the medical literature of the coexistence of systemic brucellosis with pancreatic tuberculosis. We suggest that the possibility of the coexistence of brucellosis with tuberculosis be kept in mind when assessing pancreatitis patients in endemic regions and in individuals with occupational risk hazards.

Keywords

EN

Pancreatitis; Tuberculosis; Brucellosis

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2010
• Volume: 5
• Issue: 5
• Pages: 573-576

Dates

published

1 - 10 - 2010

online

20 - 8 - 2010

Contributors

author

Ali Acar

• Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey

author

İlker Sücüllü

• Department of General Surgery, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey

author

Orhan Baylan

• Department of Medical Microbiology, Gulhane Military Medical Academy Haydarpasa Training Hospital, Uskudar-Istanbul, 34668, Istanbul, Turkey

author

Ali Filiz

• Department of General Surgery, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey

author

Hüsrev Diktaş

• Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey

author

Mert Kıvanc

• Acibadem Hospital, 34457, Istanbul, Turkey

author

Oral Öncül

• Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey

author

Levent Görenek

• Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey

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Identifiers

DOI

10.2478/s11536-009-0143-1