Abstract
Introduction: Brucellosis is a common zoonotic disease which has a wide spectrum of clinical manifestations and complications in
humans. Brucellosis is an endemic disease in Iran. The aim of this case report was to introduce acute hepatitis as a rare complication of
acute brucellosis.
Case Presentation: First case, a 25-year-old man, who complained from fever, chillness, nocturnal sweating, nausea, vomiting, jaundice,
and right upper quadrant pain, and was admitted to the hospital. Laboratory tests showed a five-fold increase in alanine aminotransferase
and aspartate aminotransferase levels, and increased total and direct bilirubin and alkaline phosphatase levels. Second case, a 63-year-old
man, who complained from fever, chillness, weight loss, malaise and nocturnal sweating, and was admitted to the hospital. Laboratory
tests showed an eight-fold increase in alanine aminotransferase and aspartate aminotransferase levels, and increased total and direct
bilirubin and alkaline phosphatase levels. The patient had jaundice at the third day of admission. The results of seroagglutination tests,
Wright and 2-mercaptoethanol (2ME) were positive for both patients. The patients were diagnosed as having acute brucella hepatitis and
were treated with standard regimen of anti-brucella drugs and improved completely after six weeks of treatment.
Conclusions: Brucellosis must be considered in the differential diagnosis of acute hepatitis in patients with jaundice and fever
manifestations especially if there is a history of unpasteurized dairy products ingestion and life in endemic areas because early diagnosis
and treatment of the patient can decrease complications and mortality rate.