Brucellosis is a disease of protean manifestations. Symptoms
typically develop 2 to 3 weeks after exposure and can be acute or
insidious. Fever is an almost invariable component of the illness
and may wax and wane over a prolonged period of time in untreated
patients, hence the name, undulant fever. The classical triad of
brucellosis consists of fever, arthralgia or arthritis, and organomegaly,
often associated with night sweats, malaise, weight loss, and anorexia.
Physical examination findings may be scarce and include joint tenderness,
splenomegaly or hepatomegaly, and rarely arthritis.4,6,7 Congenital
brucellosis has been described, and the infection can be transmitted
via breast milk.8,9 The illness spectrum varies
from mild febrile illness to major systemic disease with endocarditis, meningitis,
arthritis, or osteomyelitis. The disease is sometimes localized
to a single organ, such as the musculoskeletal, pulmonary, cardiovascular,
or neurologic systems.1