Hepatitis Associated With Undulant Fever

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HEPATITIS with jaundice may occur in the course of human Brucella infection although the paucity of published accounts of hepatic involvement in brucellosis indicates that it is uncommon. However, as shown by the autopsy material of Hughes1 and findings in the liver in specimens obtained by needle biopsy in proved cases of brucellosis,2 it is evident that pathologic changes in the liver may be a common result of this infection. Jaundice and a positive culture for Brucella organisms in the bile may indicate origin in the gallbladder or duct and are possible manifestations of hepatic involvement. Additional verifications of this theory appear in the experimental work of Amoss.3 He infected guinea pigs with Brucella organisms and showed that these organisms caused focal lesions in the liver, spleen and lymph nodes. The reactions around these focal areas start as an exudative inflammatory process and lead to the formation of granulomatous nodules which contain a central necrotic mass.

Chaikin and Schwimmer4 reported a case of hepatitis associated with undulant fever in which jaundice was the first symptom.

A patient who was recently admitted to the Cleveland Clinic illustrates the usual clinical and laboratory evidence of hepatitis associated with brucellosis proved by a positive culture for B. abortus in the blood.

Case Report

A white grocery merchant, age 33, was admitted to the Cleveland Clinic in November, 1947, with the complaint of fever and jaundice. He had become ill in 1943 while on duty at the Great Lakes Naval Training Station. Attacks of. . .



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