Brucella Melitensis As Causative Agent for Neck Abscess in an

Abstract

Background: Brucellosis, a zoonotic disease, is verycommon in the Mediterranean basin and a major concernin livestock areas. We present a rare case of a Brucellacausedabscess in the neck of a stock-breeder in anendemic Greek area.Case Report: A 39-year-old male, living in the ruralarea of Thessaly, presented with a mass in the left areaof his neck. Clinical examination and imaging testsrevealed an abscess in the left sternocleidomastoidmuscle. Sampling of the abscess by fine-needleaspiration yielded inflammatory fluid (17x103 cells/?L). Molecular sequencing (16S rRNA polymerasechain reaction) performed directly in the clinical sampleidentified the presence of Brucella melitensis within24 hours after material sampling. The microorganismwas isolated in agar media four days later. The RoseBengaltest was negative, while the Brucellacapt testshowed titer 1/320. Given the results obtained with thesemolecular techniques, the patient was offered treatmentwith streptomycin (1 g for 3 weeks) and oral doxycycline(100 mg twice daily for 6 weeks), concurrently.Conclusion: In areas endemic for brucellosis, theinvestigation of a patient with a neck abscess shouldinclude Brucella spp. among possible causative agents.