A case of PUO-Human Brucellosis

Brucellosis is also known as undulant fever, Mediterranean fever or Malta fever,is a zoonosis and the infection is almost invariably transmitted by direct or indirect contact with infected animals or their products. It is essentially a disease of animals, especially domesticated livestock,caused by bacteria of the Brucella group with humans as an accidental host. The human disease usually manifests itself as an acute febrile illness which may persist and progress to a chronically incapacitating disease with severe complications. The clinical picture is not specific and requires support with the laboratory tests.In absence of specific treatment,the disease may persist for weeks or months leading to cardiovascular and neurological complications . The duration of the human illness and its long convalescence means that brucellosis is an important economic as well as a medical problem for the patient because of time lost from normal activities. Our case is a 35 year old male farmer presenting with fever and behavioural disturbances, an atypical presentation, which would have been misdiagnosed without high index of suspicion.Thus it emphasizes that physicians should consider the diagnosis of Brucellosis in certain groups like farmers ,farm workers,shephards, veterans, laboratory workers,etc.