Perforation of the Terminal Ileum Caused by Brucellosis: A Case Report

Brucellosis is a zoonotic disease caused by infection with gram-negative coccobacilli belonging to the genus Brucella, resulting in invasion of multiple systems and organs. Bone and joint involvement are its most common complication. Acute abdomen with intestinal perforation caused by Brucella infection is very rare. Here we report a case in a 69-year-old man who was diagnosed with acute diffuse peritonitis with hollow organ perforation before surgery. Exploration during the operation revealed intestinal perforation at the end of ileocecum, with wheel spoke-like necrosis at the end of ileum. Partial resection of the necrotic small intestine, closure of the end of ileum and ileostomy were performed. Postoperative blood culture and a Brucella agglutination test were both positive for Brucella. Targeted treatment with tetracycline and aminoglycosides was given. The patient recovered and was discharged.