Splenic Infarction Associated with Brucellosis in a Non-Endemic Area

A 45-year-old man was referred from a local clinic with persistent fever, intermittent pain in the left upper abdomen, and weight loss of 7 kg. He quit his animal husbandry 18 months ago when his cows were found to be infected with Brucella. Abdominal computed tomography (CT) scan taken on admission showed splenomegaly with a wedge-shaped hypoattenuating region in the enhanced image, which was consistent with splenic infarction. Serology for Bruculla was strongly positive with the standard tube agglutination test (1/2560). After initiation of doxycycline (100 mg every 12 hrs) and rifampin (600 mg every day), the patient's condition improved, and was discharged with oral antibiotics that were to be continued for 3 months. During the 12 months' follow up at the outpatient department, the patient had no symptoms, and the last agglutination titer for Brucella in serum had decreased to 1/40. To our knowledge, this is the first report on splenic infarction associated with brucellosis in Korea, which was treated successfully with antibiotic therapy.