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CHRONIC BRUCELLAR PYELONEPHRITIS SIMULATING TUBERCULOSIS

Robert S. Abemathy, M.D.; William E. Price, M.D.; Wesley W. Spink, M.D.
JAMA. 1955;159(16):1534-1537. doi:10.1001/jama.1955.02960330034010c.
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The response to infection with Brucella is characterized by the formation of granulomatous lesions, particularly in those organs comprising the reticuloendothelial system. While the majority of patients with brucellosis recover without residual effects, chronic localized infections may involve the bones, joints, bursae, meninges, endocardium, lungs, liver, spleen, epididymides, testes, and kidneys. Such infections mimic tuberculosis and often cannot be differentiated histologically from tuberculosis. The present report is concerned with a patient in whom both the clinical course and pathological findings of brucellosis closely simulated tuberculosis. In addition, the patient presented several unusual features of brucellar infection. Localization of the disease in the urinary tract is an infrequently reported complication, while caseation of the tissues is a rare phenomenon in human brucellosis.

REPORT OF A CASE

A 46-year-old man was in apparent excellent health until April, 1954, when persistent urinary frequency, nocturia, and dysuria developed. In June, 1954, during an episode

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