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Infectious Disorders - Drug Targets

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ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

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Case Report

Multiple Myeloma or Brucellosis: A Case Report

Author(s): Hossein A. Rahdar, Mansoor Kodori, Mohamad R. Salehi, Mahsa Doomanlou, Morteza Karami-Zarandi, Seyedesomaye Jasemi and Mohammad M. Feizabadi*

Volume 20, Issue 1, 2020

Page: [102 - 105] Pages: 4

DOI: 10.2174/1871526519666190307123047

Price: $65

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.

Graphical Abstract

[1]
Seleem, M.N.; Boyle, S.M.; Sriranganathan, N. Brucellosis: a re-emerging zoonosis. Vet. Microbiol., 2010, 140(3-4), 392-398.
[http://dx.doi.org/10.1016/j.vetmic.2009.06.021] [PMID: 19604656]
[2]
Mirnejad, R.; Jazi, F.M.; Mostafaei, S.; Sedighi, M. Epidemiology of brucellosis in Iran: A comprehensive systematic review and meta-analysis study. Microb. Pathog., 2017, 109, 239-247.
[http://dx.doi.org/10.1016/j.micpath.2017.06.005] [PMID: 28602839]
[3]
Marvi, A.; Asadi-Aliabadi, M.; Darabi, M.; Abedi, G.; Siamian, H.; Rostami-Maskopaee, F. Trend analysis and affecting components of human brucellosis incidence during 2006 to 2016. Med. Arh., 2018, 72(1), 17-21.
[http://dx.doi.org/10.5455/medarh.2018.72.17-21] [PMID: 29416212]
[4]
Bosilkovski, M.; Kamiloski, V.; Miskova, S.; Balalovski, D.; Kotevska, V.; Petrovski, M. Testicular infection in brucellosis: Report of 34 cases. J. Microbiol. Immunol. Infect., 2018, 51(1), 82-87.
[PMID: 27036087]
[5]
Dean, A.S.; Crump, L.; Greter, H.; Hattendorf, J.; Schelling, E.; Zinsstag, J. Clinical manifestations of human brucellosis: a systematic review and meta-analysis. PLoS Negl. Trop. Dis., 2012, 6(12), e1929
[http://dx.doi.org/10.1371/journal.pntd.0001929] [PMID: 23236528]
[6]
Galińska, E.M.; Zagórski, J. Brucellosis in humans--etiology, diagnostics, clinical forms. Ann. Agric. Environ. Med., 2013, 20(2), 233-238.
[PMID: 23772567]
[7]
Franco, M.P.; Mulder, M.; Gilman, R.H.; Smits, H.L. Human brucellosis. Lancet Infect. Dis., 2007, 7(12), 775-786.
[http://dx.doi.org/10.1016/S1473-3099(07)70286-4] [PMID: 18045560]
[8]
Ertek, M.; Yazgi, H.; Kadanali, A.; Özden, K. TAŞYARAN MA. Complications of Brucella infection among adults: an 18-year retrospective evaluation. Turk. J. Med. Sci., 2007, 36(6), 377-381.
[9]
Wang, Y.; Zhang, W.; Ke, Y.; Zhen, Q.; Yuan, X.; Zou, W.; Li, S.; Sun, Y.; Wang, Z.; Wang, D.; Cui, B.; Song, H.; Huang, L.; Chen, Z. Human brucellosis, a heterogeneously distributed, delayed, and misdiagnosed disease in china. Clin. Infect. Dis., 2013, 56(5), 750-751.
[http://dx.doi.org/10.1093/cid/cis980] [PMID: 23175566]
[10]
10.Laurent FJ, Provost F, Boiron P. Rapid identification of clinically relevant Nocardia species to genus level by 16S rRNA gene PCR. J. Clin. Microbiol., 2000, 38(7), 2805.
[11]
Rahdar, H.A.; Golmohammadi, R.; Mirnejad, R.; Ataee, R.A.; Alishiri, G.H.; Kazemian, H. Diversity of virulence genes in Brucella melitensis and Brucella abortus detected from patients with rheumatoid arthritis. Microb. Pathog., 2018, 118, 247-250.
[http://dx.doi.org/10.1016/j.micpath.2018.03.034] [PMID: 29578063]
[12]
Solera, J. Update on brucellosis: therapeutic challenges. Int. J. Antimicrob. Agents, 2010, 36(Suppl. 1), S18-S20.
[http://dx.doi.org/10.1016/j.ijantimicag.2010.06.015] [PMID: 20692127]
[13]
Karakukcu, M.; Patiroglu, T.; Ozdemir, M.A.; Gunes, T.; Gumus, H.; Karakukcu, C. Pancytopenia, a rare hematologic manifestation of brucellosis in children. J. Pediatr. Hematol. Oncol., 2004, 26(12), 803-806.
[PMID: 15591899]
[14]
Citak, E.C.; Citak, F.E.; Tanyeri, B.; Arman, D. Hematologic manifestations of brucellosis in children: 5 years experience of an anatolian center. J. Pediatr. Hematol. Oncol., 2010, 32(2), 137-140.
[http://dx.doi.org/10.1097/MPH.0b013e3181ced382] [PMID: 20147850]
[15]
Sevinc, A.; Buyukberber, N.; Camci, C.; Buyukberber, S.; Karsligil, T. Thrombocytopenia in brucellosis: case report and literature review. J. Natl. Med. Assoc., 2005, 97(2), 290-293.
[PMID: 15712797]
[16]
Crosby, E.; Llosa, L.; Miro Quesada, M.; Carrillo, C.; Gotuzzo, E. Hematologic changes in brucellosis. J. Infect. Dis., 1984, 150(3), 419-424.
[http://dx.doi.org/10.1093/infdis/150.3.419] [PMID: 6481187]
[17]
Gotuzzo, E.; Carrillo, C.; Guerra, J.; Llosa, L. An evaluation of diagnostic methods for brucellosis--the value of bone marrow culture. J. Infect. Dis., 1986, 153(1), 122-125.
[http://dx.doi.org/10.1093/infdis/153.1.122] [PMID: 3941276]
[18]
Rajkumar, S.V.; Dimopoulos, M.A.; Palumbo, A.; Blade, J.; Merlini, G.; Mateos, M-V.; Kumar, S.; Hillengass, J.; Kastritis, E.; Richardson, P.; Landgren, O.; Paiva, B.; Dispenzieri, A.; Weiss, B.; LeLeu, X.; Zweegman, S.; Lonial, S.; Rosinol, L.; Zamagni, E.; Jagannath, S.; Sezer, O.; Kristinsson, S.Y.; Caers, J.; Usmani, S.Z.; Lahuerta, J.J.; Johnsen, H.E.; Beksac, M.; Cavo, M.; Goldschmidt, H.; Terpos, E.; Kyle, R.A.; Anderson, K.C.; Durie, B.G.; Miguel, J.F. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol., 2014, 15(12), e538-e548.
[http://dx.doi.org/10.1016/S1470-2045(14)70442-5] [PMID: 25439696]

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