A case of brucellosis with abscess of the iliacus muscle, olecranon bursitis, and sacroiliitis.

ABSTRACT

Brucellosis is a systemic infection involving many organs and tissues. The musculoskeletal system is one of the most commonly affected. The disease can present with sacroiliitis, peripheral arthritis, spondylitis, paraspinal abscess, bursitis, and osteomyelitis. A 25-year-old male patient was admitted with fever of 20-day duration, right-sided hip pain, and night sweating. A Brucella standard tube agglutination test was positive at a titer of 1/160. Magnetic resonance imaging (MRI) of the hip joint showed right sacroiliitis and a hyperintense, nodular, lobulated mass within the right iliacus muscle, consistent with abscess. The patient was started on intramuscular streptomycin at a dose of 1 g/day, oral rifampin 600 mg/day, and doxycycline 200 mg/day. On day 20 of treatment, the patient was admitted with swelling and pain over the left elbow for the past week. MRI of the left elbow was performed, which showed fluid edema suggestive of olecranon bursitis. Taking the patient's complaints into consideration, rifampin and doxycycline treatment were maintained for a year. Pain at the hip joint and elbow resolved and MRI findings disappeared. Abscess of the iliacus muscle, which has not been reported before, and the olecranon bursitis that developed during treatment make this case worth presenting.