Spontaneous bacterial peritonitis due to Brucella Melitensis in a cirrhotic patient

Turk J Gastroenterol. 2005 Mar;16(1):38-40.

Abstract

Spontaneous bacterial peritonitis is a well-known entity, with a reported incidence of 15-20% in advanced cirrhotic patients. Escherichia coli and Klebsiella pneumoniae are the most common causes of spontaneous bacterial peritonitis; Brucella is extremely rare. We aimed to present one case of such a rare condition in a cirrhotic patient who also had hepatocellular carcinoma. Routine laboratory tests, abdominal ultrasonography and peritoneal fluid examinations were studied in a cirrhotic patient with ascites. Peritoneal fluid white blood cell count was 1300/mm3, with lymphocyte predominance (80%). Peritoneal fluid and blood culture both yielded Brucella melitensis. The patient also had a mass in the right lobe of the liver confirmed as hepatocellular carcinoma by biopsy. Brucella should be suspected as a cause of spontaneous bacterial peritonitis in cirrhotic patients with no response to standard spontaneous bacterial peritonitis treatments and with immunodeficiency such as hepatocellular carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Ascitic Fluid / microbiology
  • Biopsy
  • Brucella melitensis / isolation & purification*
  • Brucellosis / complications
  • Brucellosis / microbiology*
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / pathology
  • Fatal Outcome
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / pathology
  • Liver Neoplasms / complications
  • Liver Neoplasms / pathology
  • Male
  • Peritonitis / complications
  • Peritonitis / microbiology*