Acute and Chronic Hepatic Involvement of Brucellosis

Two patients with brucellosis are presented; one with acute hepatitis and the other with a chronic draining sinus at the right costal margin which originated from an abscess of the liver. Brucella abortus infection may be manifest by nonspecific hepatic inflammation or, occasionally, by granulomatous hepatitis. Rarely, cirrhosis may result i f untreated. Chronic hepatic and splenic involvement, which is characterized by tissue calcification, can be seen in Brucella suis infection. Suppurative complications may develop after many years of dormancy. This variable response to Brucella infection seems related to species differences and perhaps differing immune response in the host. Because Brucella suis has been more commonly recovered in recent years, more patients with chronic hepatic and splenic involvement may be seen in the future this spectrum of liver involvement in brucellosis. In both cases, a careful occupational history and earlier consideration of the possibility of brucellosis might have expedited appropriate diagnosis and treatment.