Brucellosis as a Primary Cause of Peroneal Tenosynovitis: A Case Report and Literature Review/ Bruselloza Bagli Peroneal Tenosinovit: Bir Olgu Sunumu ve Literaturun Gozden Gecirilmesi

Tenosynovitis is a rare complication in the course of brucellosis, and may cause relapse if it is not treated with appropriate treatment options. We describe a case of peroneal tenosynovitis primarily associated with Brucella, the first one reported in the literature to the best of our knowledge. A 45-year-old woman suffering from fever and night sweating in addition to her right ankle pain, redness and swelling for a month was admitted. Standard tube agglutination (STA) test was found to be positive with a titer of 1/320. The patient was diagnosed with brucellosis and treated with a combination of doxycycline and rifampicin for six weeks. Her complaints disappeared after the treatment, but two months later she applied again with a similar clinical picture. In the second admission, STA and rivanol tube agglutination tests were positive with a titer of 1/640 and 1/320, respectively. Magnetic resonance imagining of the right ankle joint showed extensive tenosynovitis of the right peroneal tendons, and effusion of subtalar joint associated with synovitis. She was accepted as relapsed brucellosis complicated by peroneal tenosynovitis according to the clinical, laboratory and radiological findings. After 12 weeks of ciprofloxacin and cotrimoxazole, and 3 weeks of streptomycin treatment, she fully recovered without any failure or relapse. Klimik Dergisi2018; 31(3): 247-50. Key Words: Brucellosis, tenosynovitis, relapse. Tenosinovit, bruselloz seyrinde nadir gorulen bir komplikasyondur ve uygun tedavi secenekleriyle tedavi edilmezse nukse neden olabilir. Bu bildiride birincil olarak Brucella ile iliskili bir peroneal tenosinovit olgusu sunulmustur. Bildigimiz kadariyla, bu olgu literaturde bildirilen ilk olgudur. 45 yasinda kadin, bir aydir suren ates ve gece terlemesine ek olarak sag ayak bileginde agri, kizariklik ve sisme sikayetleriyle basvurdu. Standard tup aglutinasyon (STA) testi 1/320 titrede pozitif bulunan hasta, bruselloz tanisi konularak doksisiklin ve rifampisin kombinasyonuyla alti hafta sureyle tedavi edildi. Tedaviden sonra sikayetleri ortadan kalkti; ancak iki ay sonra benzer bir klinik tabloyla tekrar basvurdu. Hastanin ikinci basvurusunda STA ve rivanollu tup aglutinasyon testleri, sirasiyla 1/640 ve 1/320 titrelerde pozitif bulundu. Sag ayak bileginin manyetik rezonans goruntulemesinde, sag peroneal tendonlarda yaygin tenosinovit ve sinovitle iliskili subtalar eklem efuzyonu saptandi. Klinik, laboratuvar ve radyolojik bulgulara dayanarak peron