Brusella Enfeksiyonunun Nadir Osteoartiküler Tutulumu: Kitle Şeklinde Ortaya Çıkan Prepatellar Bursit

Year 2025, Volume: 6 Issue: 3, 350 - 355, 28.09.2025

Teoman Bekir Yeni , Batuhan Gencer , Mehmet Murat Arslan , Ahmet Çulcu , Özgür Doğan

https://doi.org/10.47482/acmr.1600529

Abstract

Arka plan: Brusella enfeksiyonunun osteoartiküler tutulumu artrit, bursit, tenosinovit veya spondilit şeklinde ortaya çıkabilir. Brusella enfeksiyonunun izole olarak bursit şeklinde görülmesi nadir bir tutulumdur. Bu sunumun amacı, osteoartiküler tutulum olarak izole prepatellar bursit ile başvuran iki Brucella enfeksiyonu olgusunu sunmaktır.
Yöntemler: İlk olgumuz 56 yaşında kadın olup son bir yıldır sol dizde şişlik ve minimal ağrı şikayeti ile başvurdu. İkinci olgumuz 53 yaşında erkek hasta olup iki yıl önce başlayan ve giderek kötüleşen dizde ağrısız şişlik şikayeti ile başvurdu. Fizik muayenede her iki hastada da eritem, sıcaklık veya hassasiyet olmaksızın sol dizin anteriorundan lateraline uzanan şişlik gözlendi. Laboratuvar incelemesinde biyokimyasal parametreler, tam kan sayımı ve eritrosit sedimantasyon hızı (ESH) normaldi. Serolojik testlerde Brucella IgG pozitifliği saptandı.
Sonuçlar: Tetkiklerin ardından cerrahi planlandı. Longitudinal bir insizyonla kitlelere ulaşıldı ve tamamen eksize edildi. Rezeke edilen dokunun patolojik incelemelerinde kronik granülomatöz inflamasyon saptandı.
Sonuçlar: Ülkemiz gibi endemik bölgelerde, Brucella bursiti, anamnezde herhangi bir özellik varlığına bakılmaksızın, izole ve şüpheli osteoartiküler tutulum bağlamında düşünülmelidir. Klinik şüphe, Brucella bursitinin ön tanısında çok önemli bir rol oynamakta ve klinisyenlere hastalığın erken tanısı ve etkili tedavisi konusunda yol göstermektedir.

Keywords

osteoartiküler tutulum , prepatellar bursit , diz ağrısı , hayvancılık. , brusella enfeksiyonu

Rare Osteoarticular Involvement of Brucella Infection: Prepatellar Bursitis Presenting as A Massive Mass

Abstract

The osteoarticular involvement of Brucella infection may present as arthritis, bursitis, tenosynovitis, or spondylitis. Isolated presentation of Brucella infection as bursitis is a rare occurrence. The objective of this report was to present two cases of Brucella infection presenting with isolated prepatellar bursitis as osteoarticular involvement. The initial case report concerns a 56-year-old female patient who presented with a complaint of swelling in the left knee, accompanied by minimal pain, which had been present for the previous year. The second patient was a 53-year-old male patient who presented with a complaint of painless swelling in the knee, which had first appeared two years prior and had progressively worsened. Physical examination observed swelling extending from the anterior to the lateral side of the left knee, with no erythema, warmth, or tenderness observed in both patients. Laboratory examinations revealed normal biochemical parameters, complete blood count, and erythrocyte sedimentation rate (ESR), but C-reactive protein (CRP) levels were three times higher than the cut-off value. Serological tests revealed Brucella IgG positivity. Following the investigations, surgery was planned, and through a longitudinal incision, the masses were reached and completely excised. The resected tissue’s pathological examinations revealed chronic granulomatous inflammation. In endemic regions such as the one under consideration here, Brucella bursitis should be considered in the context of isolated and suspected osteoarticular involvement, regardless of the presence of any features in the patient’s history. Clinical suspicion plays a pivotal role in the preliminary diagnosis of Brucella bursitis, guiding clinicians in the early diagnosis and effective treatment of the disease.

Keywords

Brucella infection , osteoarticular involvement , prepatellar bursitis , knee pain , animal husbandry.

Ethical Statement

Ethics committee approval was not obtained since the present study was a case report. Written informed consent forms were obtained from both patients.

Supporting Institution

The authors declared that this study has received no financial support.

Thanks

None

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