Brucella Induced Thyroiditis : Case Report and Literature Review

Abstract

Brucellosis is a zoonotic disease that can affect multiple organs and tissues in the human body with various clinical presentations; however the thyroid gland is rarely involved. There are many species of Brucella, but only a few can cause symptomatic infections to humans, with Brucella melitenses being the most common. Here we report a case of Brucella induced thyroiditis which presented with pyrexia of unknown origin (PUO) and a neck swelling. The patient had abnormal thyroid function test and a positive Brucella serum agglutination. Early diagnosis and appropriate anti Brucella management showed great response and the patient fully recovered. we hope to shed some light on this rare complication of Brucella infection through our study. We have conducted a literature review of six cases that reported the same condition with some notable differences. We believe that it is crucial to include brucellosis in the deferential diagnosis of any patient presenting PUO especially when there is a positive history of unpasteurized dairy product consumption.

Acute Thyroiditis Associated with Brucellosis: A Case Report

“…Brucella thyroiditis is more often observed in women [3,4,5,8,9,10,11,13]. In men, as in our case, it is very rare [6,7,14] and the reason for such gender distribution still remains unclear.…”

“…In brucella thyroiditis, parameters of inflammation vary from slightly [5,8], to moderately elevated [7,11], while thyroid function tests are usually within normal range [7,10,13]. However, deviations are possible, like lower TSH and elevated T4 [3,5,9,11].…”

“…On several occasions brucellosis was not recognized on time and treatment initiation was postponed, which resulted with thyroid gland abscess formation [5,6,7]. After adequate treatment the outcome in patients with brucella thyroiditis was favorable [7,9,10,11].…”

“…It is an extremely rare condition and less than 20 cases are reported in the literature, almost exclusively as case reports. In the descriptions, predominated cases with thyroid gland abscess [4][5][6][7][8], but also acute [9][10][11],…”