Bruselloz nadir bir komplikasyonu: pulmoner tromboemboli

Abstract

Brusellozda vasküler komplikasyonlar nadir görülmesine rağmen, literatürde çeşitli arteriyel ve venöz tıkanıklık vakaları bildirilmiştir. Ancak bruselloz ile pulmoner tromboemboli birlikteliği oldukça sey-rektir. Bu olgu sunumunda, bruselloz ve pulmoner tromboembolinin eşzamanlı olarak görüldüğü bir hastanın klinik özelliklerinin paylaşılması amaçlanmıştır. Kırk sekiz yaşında erkek hasta, nefes darlığı, göğüs ağrısı, ateş, halsizlik ve kilo kaybı şikayetleri ile başvurdu. Yapılan tetkiklerde, pulmoner bilgi-sayarlı tomografi anjiyografide sol akciğer alt lob segmenter dalda dolum defekti saptandı, laboratuvar testlerinde ise Brucella serum aglütinasyon testi 1/1280 pozitif bulundu. Hastada bruselloz ve pulmoner tromboemboli tanılarının doğrulanmasını takiben, hastaya doksisiklin, trimetoprim-sülfametoksazol, rifampisin ve antikoagülan tedaviyi içeren kombine tedavi rejimi başlandı. Tedavi sonrası klinik düzel-me sağlandı. Endemik bölgelerde bruselloz hastalarında pulmoner tromboemboli riskinin göz önünde bulundurulması ve venöz tromboembolizm tanısı alan hastalarda brusellozun tetikleyici bir faktör ola-bileceği düşünülmelidir.

Keywords

• Bruselloz
• Venöz Tromboembolizm
• Derin Ven Trombozu
• Pulmoner Tromboemboli

A rare complication of brucellosis: pulmonary thromboembolism

Abstract

Vascular complications are rare in brucellosis, although various arterial and venous occlusive events have been reported in the literature. However, the coexistence of brucellosis and pulmonary thrombo-embolism is exceedingly uncommon. In this case report, we aim to present the clinical features of a pati-ent in whom brucellosis and pulmonary thromboembolism occurred simultaneously. A 48-year-old male patient presented with complaints of dyspnea, chest pain, fever, fatigue, and weight loss. Computed tomography pulmonary angiography revealed a filling defect in the segmental branch of the left lower lobe, and laboratory tests showed a Brucella serum agglutination titer of 1:1280. Following confirma-tion of brucellosis and pulmonary thromboembolism, a combined treatment regimen including doxycyc-line, trimethoprim-sulfamethoxazole, rifampicin, and anticoagulant therapy was initiated. Clinical imp-rovement was achieved after treatment. In endemic regions, the risk of pulmonary thromboembolism should be considered in patients with brucellosis, and brucellosis should be regarded as a potential precipitating factor in individuals diagnosed with venous thromboembolism.

Keywords

• Brucellosis
• Venous Thromboembolism
• Deep Vein Thrombosis
• Pulmonary Thromboembolism

References

1. 1. Dadar M, Shahali Y, Whatmore AM. Human brucello-sis caused by raw dairy products: occurrence, major risk factors and prevention. Int J Food Microbiol. 2019;292:39-47.
2. 2. Onurdağ F, Ökten S, Şen B. Screening Brucella spp. in bovine raw milk by real-time quantitative PCR and con-ventional methods in a pilot region of vaccination, Edirne, Turkey. J Dairy Sci. 2016;99(5):3351-7.
3. 3. Qureshi KA, Parvez A, Fahmy NA, et al. Brucellosis: epidemiology, pathogenesis, diagnosis and treatment – a comprehensive review. Ann Med. 2023;55(2):2295398.
4. 4. Koubaa M, Frigui M, Cherif Y, et al. Deep vein throm-bosis associated with acute brucellosis: a case report and review of the literature. Korean J Intern Med. 2013;28(5):628-30.
5. 5. Colling ME, Tourdot BE, Kanthi Y. Inflammation, infection and venous thromboembolism. Circ Res. 2021;128(12):2017-36.
6. 6. Huisman M, Barco S, Cannegieter SC, et al. Pulmonary embolism. Nat Rev Dis Primers. 2018;4:18028.
7. 7. Buzgan T, Karahocagil MK, Irmak H, et al. Clinical manifestations and complications in 1028 cases of bru-cellosis: a retrospective evaluation and review of the literature. Int J Infect Dis. 2010;14(6):e469-78.
8. 8. Bosilkovski M, Krteva L, Dimzova M, et al. Human brucellosis in Macedonia: ten years of clinical experience in an endemic region. Croat Med J. 2010;51(4):327-36.

9. 9. Pastori D, Cormaci VM, Marucci S, et al. A comprehen-sive review of risk factors for venous thromboembolism: from epidemiology to pathophysiology. Int J Mol Sci. 2023;24:3169.
10. 10. Pati I, Masiello F, Piccinini V, et al. Risk of venous thromboembolism in infectious diseases: a literature review. Pathogens. 2025;14:816.
11. 11.Sarkisyan NS, Kulichenko AN. Significance of endot-helial dysfunction in the pathogenesis of brucellosis. Infect Dis (News, Opinions, Training). 2023;12(1):105-9.
12. 12. Ghafouri M, Danafar M, Shokri A. Rare case of deep vein thrombosis associated with brucellosis in Iran. Clin Case Rep. 2021;9:e04969.
13. 13. Gupte S, Kaur T. Diagnosis of human brucellosis. J Trop Dis. 2015;4:185.
14. 14. Vection S, Laine CG, Arenas-Gamboa AM. What do we really know about brucellosis diagnosis in livestock worldwide? A systematic review. PLoS Negl Trop Dis. 2025;19(6):e0013185.
15. 15. Şimşek Yavuz S, Özger S, Benli A, et al. Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Kanıta Dayalı Bruselloz Tanı ve Tedavi Klinik Uygulama Reh-beri. Klimik Derg. 2023;36(2).
16. 16. Thomas SE, Weinberg I, Schainfeld RM, et al. Diagno-sis of pulmonary embolism: evidence-based approaches. J Clin Med. 2024;13(13):3722.
17. 17. De Jong CMM, Kroft LJM, van Mens TE, et al. Mo-dern imaging of acute pulmonary embolism. Thromb Res. 2024;238:105-16.
18. 18. Ebner M, Lankeit M. Antithrombotic treatment of pulmonary embolism. Dtsch Med Wochenschr. 2020;145(14):970-7..