Pulmonary Manifestations of Brucellosis

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Pulmonary brucellosis has received scant attention, although it has long been known that all three types of brucellosis may attack any body tissue. As early as 1861, in discussing Malta fever, Marston1 wrote: “There is no fever so irregular in its course and symptoms.” Craig2 in 1906 said: “ It is extremely difficult to describe accurately all the forms which this truly protean disease may assume.” The largest number of autopsies in brucellosis have been reported by Hughes.3 He frequently noted pleural adhesions, pleural effusion, and patchy or lobular consolidation. Others have more recently reported pulmonary involvement. Bogart4 described massive bronchopneumonic infiltration due to both acute and chronic inflammation. Beatty5 thinks the most common pulmonary manifestation is hilar and bronchovascular infiltration and reported 12 patients showing this finding. Hemoptysis with tracheal ulceration,5,6 infiltration and consolidation,6,7,8,9,10,11,12 unresolved pneumonia,6 lung abscess,9 and pleural effusion9 have been recorded by others. Hardy9 once recovered the Brucella from pleural fluid by guinea pig inoculation. Debono9 found positive blood cultures in patients with lung involvement.

The following group of patients is reported to illustrate various types of pulmonary diseases observed in the study of several hundred patients with brucellosis at Cleveland Clinic. Most patients had a chronic type of infection.

Case 1. A white man, aged 48, entered Cleveland Clinic May 10, 1938, with a dry, hacking cough and substernal discomfort of five weeks’ duration. There was also a history of headaches, chills, fever, drenching sweats, and loss of 23 pounds of weight. His temperature was. . .



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