BRUCELLOSIS - CASE-REPORT AND REVIEW OF 1 0 CASES (1973-1992) AT KANTONSSPITAL, CHUR

A 33-year-old patient from former Yugoslavia presented with low back p ain and fever. Plain X-rays and myelography were normal, but a technet ium-99m scan was suspect for vertebral osteomyelitis. Serology and blo od cultures were positive for Brucella (melitensis). Antibiotic therap y with tetracycline and rifampicine rapidly improved the signs and sym ptoms of the infection. A retrospective analysis of 11 cases of Brucel losis treated in the Kantonsspital, Chur, over the years 1973 to 1992 revealed that 9 patients were foreign workers from rural areas in the Mediterranean region (Spain, Portugal, Italy, Yugoslavia, Greece). The majority had a history of consuming milk and dairy products from thei r own farm animals up to a few months before the onset of symptoms. Bl ood cultures were positive in 5 cases (B. melitensis) while the remain ing 6 had high titers of agglutinating antibodies. A diagnostic delay of several weeks to months was typical. Because Brucellosis usually pr esents with unspecific often flu-like symptoms, with unspecific labora tory findings, and with a varying array of organ manifestations a high index of suspicion is essential for a timely diagnosis.