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Abstract

A 37-year-old woman who works as a veterinarian, with a medical history of ulcerative proctitis and xerophthalmia. Repeatedly sought care at the hospital and primary health center for urinary symptoms, initially interpreted as recurrent cystitis and empirically treated with antibiotics. Later developed myalgia and debilitating low back pain over 3 months, prompting further diagnostic investigations and referral to Orthopedics. Subsequently, she experienced progressive arthralgia and annular arthritis. Serology revealed a positive Brucella spp. IgM, leading to notification in the National Epidemiological Surveillance System (SINAVE), referral to Infectious Diseases, and initiation of targeted therapy with doxycycline (100 mg every 12 hours) and rifampicin (300 mg every 8 hours). Polymerase chain reaction (PCR) confirmed infection with Brucella melitensis, and magnetic resonance imaging (MRI) revealed a herniated disc. The instituted therapy resulted in a favorable clinical evolution. This case highlights the diagnostic challenges of brucellosis and underscores the importance of clinical suspicion in the context of occupational exposure.