Cutaneous Maculopapular Eruptions in Brucellosis: A Case Report in an Occupationally Exposed Adult

Abstract

Brucellosis is a zoonotic infection caused by Brucella species, most commonly B. melitensis and B. abortus. While systemic symptoms such as fever and arthralgia are well recognized, cutaneous manifestations are rare, occurring in only 0.4–17% of cases.

A 30-year-old male shepherd with a 10-week history of high-grade intermittent fever and severe back pain, and 2 weeks later, he developed rash. Dermatologic examination revealed multiple hyperpigmented macules and scattered erythematous papules on the back. Laboratory findings showed mild anemia (Hb 10.2 g/dL) with otherwise normal hematologic and biochemical parameters. Serology demonstrated elevated titers for Brucella abortus(1:200) and Brucella melitensis(1:80), and two sets of aerobic blood cultures became positive after 5 days using the identified Brucella spp. (species not further resolved). The patient was treated with doxycycline (100 mg twice daily for 6 weeks) and streptomycin (1 g intramuscularly daily for 2 weeks). A follow-up after 3 months, the patient remained asymptomatic with no relapse; repeat serology showed declining titers.

In occupationally exposed individuals with prolonged fever, early consideration of brucellosis and proper serologic/culture confirmation can prevent diagnostic delays, even when presentations include uncommon features such as prominent cutaneous involvement.