Unusual manifestations of brucellosis: a retrospective case series in a tertiary care Greek university hospital/Manifestations inhabituelles de la brucellose: serie de cas retrospective dans un hopital universitaire de soins tertiaires en Grece

Brucellosis remains a diagnostic puzzle. We retrospectively studied the case notes of 105 patients with brucellosis who were admitted in the Department of Internal Medicine of the University of Patras Hospital, a tertiary care institution serving an extended rural area in western Greece, from 2003 to 2006. Five unusual causes of brucellosis were identified: hepatic, epidural and thyroid abscesses, intrahepatic cholestatic liver disease and pancytopenia. Virtually every human organ and system can be involved in brucellosis, which highlights the need to include brucellosis in the differential diagnosis, especially in endemic areas. La brucellose reste une enigme en termes de diagnostic. Nous avons etudie retrospectivement les notes prises sur les cas de 105 patients atteints de brucellose, admis entre 2003 et 2006 dans le service de medecine interne de l'hopital universitaire de Patras, etablissement de soins tertiaires qui dessert une zone rurale etendue a l'ouest de la Grece. Cinq causes inhabituelles de brucellose ont ete identifiees: abces hepatique, epidural et thyroi'dien, cholestase intra-hepatique et pancytopenie. Quasiment tous les organes et systemes de l'organisme peuvent etre impliques dans cette maladie, ce qui souligne la necessite d'inclure la brucellose dans le diagnostic differentiel, en particulier les zones d'endemie.