Brucellosis as a rare cause of granulomatous hepatitis with hepatic and bone marrow granulomas: A case report

Abstract

Brucellosis may involve the liver and data on histopathology of the liver in brucellosis are limited. Brucellosis is characterized by high fever, joint-back pains and hepatosplenomegaly.In this report, a case of granulomatous hepatitis with granulomas in liver and bone marrow, who admitted to our clinic with non-specific symptoms, hepatomegaly, splenomegaly, digital clubbing, along with laboratory signs of intrahepatic cholestasis, is presented. Granulomas were detected in bone marrow and hepatic specimens of the patient. The diagnosis of brucellosis was based on isolation of Brucella mellitensis from blood culture accompanied by serum agglutination titers of 1:640. By the specific brucellosis treatment, laboratory and clinical findings were improved. Especially in endemic areas, in cases of elevated transaminase levels with the presence of related clinical findings, brucellosis should be considered . Also brucellosis should be considered in differential diagnosis of intrahepatic cholestasis and/or granulomas in hepatic and bone marrow biopsies. This case report presents various histopathological features and provides detailed information in the liver involvement of brucellosis.