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Multiple Myeloma or Brucellosis: A Case Report

[ Vol. 20 , Issue. 1 ]

Author(s):

Hossein A. Rahdar, Mansoor Kodori, Mohamad R. Salehi, Mahsa Doomanlou, Morteza Karami-Zarandi, Seyedesomaye Jasemi and Mohammad M. Feizabadi*   Pages 102 - 105 ( 4 )

Abstract:


Background: Brucellosis, a major health problem in developing countries, is a multisystem infection with a broad spectrum of clinical manifestations. Hematological complications, ranging from an intravascular coagulopathy to mild homeostasis disorders (such as gammopathy), have been reported in brucella infection. These signs and symptoms may lead to misdiagnosis of brucellosis with other hematological diseases.

Case: A 65-year-old male whose occupation was shepherding was referred to our hospital as a known case of multiple myeloma with continuous fever, muscle weakness, and night sweating after taking 2 courses of chemotherapy. The laboratory diagnosis of multiple myeloma had been based on the observation of a high percent of plasma cells in the bone marrow aspiration. At follow- up, the result of patient's fever workup, with 2 sets of blood cultures, was positive for Brucella melitensis. Isolated brucella was confirmed as B. melitensis by 16S rRNA sequencing. Brucellosis serologic test was performed by agglutination test and positive results were obtained. The patient was discharged with the cessation of fever and general improvement after the end of the parental treatment phase of brucella bacteremia.

Conclusions: Brucella infection may cause a severe disease, mimicking a primary hematological disease, which could complicate the correct diagnosis. In brucellosis cases, due to the wide range of symptoms, in addition to cultivation and serological methods, molecular methods should also be used to prevent inappropriate diagnosis and additional costs.

Keywords:

Multiple myeloma, brucella, brucellosis, hematological complications, Brucella melitensis, intravascular coagulopathy.

Affiliation:

Department of Microbiology, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Department of Microbiology, Shahid Beheshti University of Medical Sciences, Tehran, Department of infectious diseases and Tropical Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Department of infectious diseases and Tropical Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran

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