Ghenwa El Dakdouki, Doha Daoud, Roa Osman, Walid Moety, Rim Youssef, Sara Farhat
This case report highlights the importance of considering brucellosis as a cause of unexplained DVT, mainly in endemic regions, especially in the absence of a family history of hypercoagulable disorders.
INTRODUCTION: Brucella is a Gram-negative coccobacillus responsible for a zoonotic infection that is endemic in the Mediterranean region, including Lebanon. Although it commonly presents with systemic and musculoskeletal manifestations, vascular complications such as deep vein thrombosis (DVT) are rarely reported. This case highlights an uncommon thrombotic complication of brucellosis and contributes to the limited literature on brucellosis-associated DVT, particularly in endemic regions.
CASE PRESENTATION: We report the case of a previously healthy 33-year-old male from Bekaa, Lebanon, who presented with prolonged fever and bilateral lower limb pain and swelling. Doppler ultrasound confirmed bilateral DVT. Extensive investigations for thrombophilia, malignancy, and autoimmune diseases were unremarkable. Brucella indirect serology was strongly positive with a titer of 1:1280, confirming active infection. The patient was treated with streptomycin, rifampicin, doxycycline, and anticoagulation therapy, resulting in marked clinical improvement and sustained recovery during a 3-year follow-up period.
CONCLUSION: This case report highlights the importance of considering brucellosis as a cause of unexplained DVT, mainly in endemic regions, especially in the absence of a family history of hypercoagulable disorders.