Abstract
Background: Ocular brucellosis is a rare manifestation, and most references in the literature consist of case reports, resulting in a lack of data on the incidence of this condition. This study presents a case of anterior uveitis due to brucellosis in a liver transplant patient. Ocular involvement in organ transplant patients can arise from various causes; however, given the patient’s history and occupation, Brucella-related ocular involvement was strongly suspected in this case.
Case Presentation: This is the first reported case of uveitis attributed to Brucella infection in an organ transplant patient. The patient had undergone a liver transplant 10 years ago due to familial hyperlipidemia and was taking Cellcept and Tacrolimus daily as antirejection medications. Additionally, he had a background as a rancher and farmer and reported a history of consuming small amounts of raw milk, although he had not consumed it so regularly in the past. He was referred for evaluation with a two-month history of fatigue, photophobia, and a mild decrease in visual acuity, presenting in May 2022. The complicated Brucella uveitis was diagnosed by a combination of clinical manifestations, including fever, as well as epidemiological and serological findings and ophthalmological examination. The patient was treated with gentamicin, doxycycline, and cotrimoxazole in the first week and was discharged and completed a twelve-week outpatient treatment course with doxycycline 100 mg twice daily, cotrimoxazole 800/160 mg every 12 hours, and ciprofloxacin 500 mg every 12 hours. The patient’s symptoms, including ocular discomfort and fever, completely resolved within four weeks. In addition, Brucella serology tests demonstrated a decline over three months, with no relapses occurring during the subsequent 24-month follow-up period.
Conclusion: Although uveitis caused by various opportunistic infections is not uncommon among organ transplant patients who are undergoing treatment with immunosuppressive medications, it is important to specifically consider Brucella infections in areas where Brucella is endemic. In such areas, healthcare providers should perform appropriate investigations for Brucella in these cases to ensure accurate diagnosis and appropriate treatment.