A rare presentation of brucellosis: acute cholestatic hepatitis

Abstract

Brucellosis can present with clinical hepatitis and rarely as acute cholestatic hepatitis. The aim of the study is to demonstrateacute cholestatic hepatitis as a rare presentation caused by Brucella melitensis. A thirty-nine-years-old male patient was admittedto our department with the complaints of fever, malaise, fatigue and sweating. At hospitalization, the temperature was 39°C.Laboratory tests; white blood count (WBC) 4800 cells/mm3, platelet (PLT) 173000/mm3, erythrocyte sedimentation rate (ESR) 38mm/h, C-reactive protein (CRP) 257 mg/L, alanine transferase (ALT) 284 U/L, aspartate transferase (AST) 300U/L, γ-glutamyltranspeptidase (GGT) 1152 U/L, alkaline phosphatase (ALP) 1762 U/L, total bilirubin (T-Bil) 2.8 mg/dL, direct bilirubin (D-Bil)1.3 mg/dL, lactate dehydrogenase (LDH) 705 U/L. Gruber Widal test was negative. Wright serum agglutination test was foundto be positive at 1/2560 titer. Brucellosis should be kept in mind, especially in the differential diagnosis of the patients with acutehepatitis and cholestasis accompanied by fever