Brucellosis is an infectious disease caused by Gram-negative bacteria. Musculoskeletal system involvement is common in patients with brucellosis. Herein we report a patient who presented with bilateral arthralgia in the ankles and diffuse swelling of the left hand in the follow-up. He had been diagnosed with brucellosis and improved well after a 10-week duration of antibiotic therapy. Rheumatic diseases may have many infectious mimickers. Brucellosis is one of those that should be considered in the differential diagnosis.
Objective: Immune plasma therapy, a method employed for passive immunization, has been utilized as a treatment modality based on historical precedents during the Covid-19 pandemic, a global crisis resulting in the unfortunate demise of countless individuals. The objective of this study is to investigate the impact of immune plasma therapy on laboratory parameters and the overall survival rate in patients with Covid-19 pneumonia. Material and Methods: Our study was designed as a retrospective analysis, conducted at a tertiary healthcare institution from April 1, 2020, to December 31, 2020. The study population comprised individuals aged 18 and above, presenting with pulmonary involvement, and diagnosed with Covid-19 using the polymerase chain reaction (PCR) method at our hospital. The inclusion criteria encompassed patients who received immune plasma therapy, as well as a control group matched for age, gender, and admission date, who did not undergo immune plasma therapy. Exclusion criteria involved patients with low serum IgA levels, those who did not provide consent for immune plasma therapy, and individuals below the age of 18. Results: The study comprised a total of 72 patients who received immune plasma therapy and 72 patients in the control group, matched for age and gender, all diagnosed with Covid-19. The median age of the patients was 70 years, ranging from 19 to 91, and 56.9% (41) of them were female. When comparing the immune plasma group with the control group, several significant differences were observed (p<0.05). These included elevated levels of leukocytes, neutrophils, neutrophil-lymphocyte ratio (NLR), glucose, aspartate aminotransferase (AST), sedimentation rate, C-reactive protein (CRP), ferritin, fibrinogen, d-dimer, and low levels of platelets and lymphocytes in the control group. Furthermore, in the immune plasma therapy group, significant associations were found between mortality and lymphocyte count, NLR, AST, CRP, and d-dimer elevation after treatment (p<0.05). Additionally, pre- and post-treatment measurements of troponin, procalcitonin, and ferritin were significantly correlated with mortality (p<0.05). Conclusion: The administration of immune plasma therapy, involving the transfer of neutralizing antibodies, has demonstrated a favorable impact on laboratory parameters and overall survival in severe cases of Covid-19 pneumonia, particularly during the early stages of the disease.
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