28 yo healthy male w/ recent travel to Africa with exposure to unpasteurized camel milk diagnosed with sacroiliitis 2/2 Brucellosis. 

Fever in a returning traveler

  • <10 days
    • Bacteria: typhoid fever, leptospirosis, rickettsia
    • Virus: dengue, zika, chikungunya, west nile, yellow fever, HIV
    • Parasite: malaria
  • >10 days
    • Bacteria: typhoid fever,TB, Q fever, brucella, tulleremia
    • Virus: HIV
    • Fungi: histoplasmosis
    • Parasite: malaria, schistosomiasis, trypanosomiasis 

Brucellosis presents with undulant fevers, night sweats, HA, malaise with complications with osteoarticular involvement> GU>Neuro involvement. You must warn lab workers so they take proper precautions if you suspect brucella. Brucella total ab titier>1:160 in serum is diagnostic. Treatment for uncomplicated infection is doxycycline + rifampin; if complicated infection -add aminoglycoside. 

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