Title:Multiple Myeloma or Brucellosis: A Case Report
Volume: 20
Issue: 1
Author(s): Hossein A. Rahdar, Mansoor Kodori, Mohamad R. Salehi, Mahsa Doomanlou, Morteza Karami-Zarandi, Seyedesomaye Jasemi and Mohammad M. Feizabadi*
Affiliation:
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran,Iran
Keywords:
Multiple myeloma, brucella, brucellosis, hematological complications, Brucella melitensis, intravascular
coagulopathy.
Abstract: Background: Brucellosis, a major health problem in developing countries, is a multisystem
infection with a broad spectrum of clinical manifestations. Hematological complications,
ranging from an intravascular coagulopathy to mild homeostasis disorders (such as gammopathy),
have been reported in brucella infection. These signs and symptoms may lead to misdiagnosis of
brucellosis with other hematological diseases.
Case: A 65-year-old male whose occupation was shepherding was referred to our hospital as a
known case of multiple myeloma with continuous fever, muscle weakness, and night sweating after
taking 2 courses of chemotherapy. The laboratory diagnosis of multiple myeloma had been
based on the observation of a high percent of plasma cells in the bone marrow aspiration. At follow-
up, the result of patient's fever workup, with 2 sets of blood cultures, was positive for Brucella
melitensis. Isolated brucella was confirmed as B. melitensis by 16S rRNA sequencing. Brucellosis
serologic test was performed by agglutination test and positive results were obtained. The
patient was discharged with the cessation of fever and general improvement after the end of the
parental treatment phase of brucella bacteremia.
Conclusions: Brucella infection may cause a severe disease, mimicking a primary hematological
disease, which could complicate the correct diagnosis. In brucellosis cases, due to the wide range
of symptoms, in addition to cultivation and serological methods, molecular methods should also
be used to prevent inappropriate diagnosis and additional costs.
