{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T06:07:27Z","timestamp":1764828447473,"version":"3.44.0"},"reference-count":24,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Spontaneous bacterial peritonitis (SBP) is a frequent form of decompensation of end-stage liver disease, with an incidence of 15\u201320% and a short-term mortality of 10\u201333%. The usual causative agents (90% of SBP) are enteric Gram-negative bacteria\u2014<jats:italic>Escherichia coli<\/jats:italic> and <jats:italic>Klebsiella pneumoniae<\/jats:italic>. Brucella is known to be a possible, but exceedingly rare, causative agent of SBP. We present the case of a 47-year-old Egyptian man, with hepatitis C cirrhosis, and a 2\u2005week history of ascites, jaundice, encephalopathy, fever and pain on his right shoulder that started while travelling in the Middle East. Laboratory and imaging studies were undertaken and he was diagnosed an SBP that failed to respond to Imipenem. Brucella was identified both in the ascitic fluid and blood; he was started on doxycycline plus rifampin with immediate clinical improvement. The antibiotic regimen was kept for 8\u2005weeks. The patient is currently under evaluation for liver transplantation.<\/jats:p>","DOI":"10.1136\/bcr-2013-008629","type":"journal-article","created":{"date-parts":[[2013,4,6]],"date-time":"2013-04-06T00:32:32Z","timestamp":1365208352000},"page":"bcr2013008629","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous bacterial peritonitis by Brucella in a cirrhotic patient"],"prefix":"10.1136","volume":"2013","author":[{"given":"Alexandre Oliveira","family":"Ferreira","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Medical School of Lisbon, Hospital Santa Maria, Lisbon, Portugal"}]},{"given":"Luis Nogueira","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Medical School of Lisbon, Hospital Santa Maria, Lisbon, Portugal"}]},{"given":"Rui Tato","family":"Marinho","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Medical School of Lisbon, Hospital Santa Maria, Lisbon, Portugal"}]},{"given":"Jos\u00e9","family":"Velosa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Medical School of Lisbon, Hospital Santa Maria, Lisbon, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2013,4,5]]},"reference":[{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1080\/0036554021000027006","article-title":"Spontaneous bacterial peritonitis due to Brucella melitensis","volume":"2013","author":"Erbay","year":"2003","journal-title":"Scand J Infect Dis"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.2","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1080\/00365540310000238","article-title":"Spontaneous bacterial peritonitis caused by Brucella melitensis","volume":"2013","author":"Gen\u00e7er","year":"2003","journal-title":"Scand J Infect Dis"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.3","first-page":"145","article-title":"Spontaneous bacterial peritonitis due to Brucella infection","volume":"2013","author":"Gursoy","year":"2003","journal-title":"Turk J Gastroenterol"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.4","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1590\/S1413-86702007000400017","article-title":"Brucella peritonitis and leucocytoclastic vasculitis due to Brucella melitensis","volume":"2013","author":"Dizbay","year":"2007","journal-title":"Braz J Infect Dis"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.5","first-page":"38","article-title":"Spontaneous bacterial peritonitis due to Brucella melitensis in a cirrhotic patient","volume":"2013","author":"Kantar\u00e7eken","year":"2005","journal-title":"Turk J Gastroenterol"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.6","first-page":"190","article-title":"Brucella: a rare causative agent of spontaneous bacterial peritonitis","volume":"2013","author":"Refik","year":"2003","journal-title":"Indian J Gastroenterol"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.7","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/S0255-0857(21)02105-8","article-title":"Review of clinical and laboratory features of human brucellosis","volume":"2013","author":"Mantur","year":"2007","journal-title":"Indian J Med Microbiol"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.8","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1016\/j.ijantimicag.2010.06.013","article-title":"The changing Brucella ecology: novel reservoirs, new threats","volume":"2013","author":"Pappas","year":"2010","journal-title":"Int J Antimicrob Agents"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.9","doi-asserted-by":"crossref","first-page":"e1929","DOI":"10.1371\/journal.pntd.0001929","article-title":"Clinical manifestations of human brucellosis: a systematic review and meta-analysis","volume":"2013","author":"Dean","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.10","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/00005792-199607000-00003","article-title":"Complications associated with Brucella melitensis infection: a study of 530 cases","volume":"2013","author":"Colmenero","year":"1996","journal-title":"Medicine (Baltimore)"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.11","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1056\/NEJMra050570","article-title":"Brucellosis","volume":"2013","author":"Pappas","year":"2005","journal-title":"N Engl J Med"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.12","first-page":"115","article-title":"Brucellosis: current epidemiology, diagnosis, and management","volume":"2013","author":"Young","year":"1995","journal-title":"Curr Clin Top Infect Dis"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.13","unstructured":"Gotuzzo E . Brucellosis. In: Guerrant RL Walker DH Weller PF , eds. Tropical infectious diseases. principles, pathogens & practice. Philadelphia: Churchill Livingstone, 1999:498."},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.14","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/S0399-077X(02)00403-1","article-title":"Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients","volume":"2013","author":"Aygen","year":"2002","journal-title":"Med Malad Infect"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.15","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1017\/S0950268804002833","article-title":"Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran","volume":"2013","author":"Hasanjani","year":"2004","journal-title":"Epidemiol Infect"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.16","first-page":"727","article-title":"Osteoarticular involvement in brucellosis: study of 196 cases in the Republic of Macedonia","volume":"2013","author":"Bosilkovski","year":"2004","journal-title":"Croat Med J"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.17","first-page":"98","article-title":"Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases","volume":"2013","author":"Geyik","year":"2002","journal-title":"Swiss Med Wkly"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.18","first-page":"41","article-title":"Natural history of brucellosis in an endemic region in different time periods","volume":"2013","author":"Bosilkovski","year":"2009","journal-title":"Acta Clin Croat"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.19","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1002\/hep.1840050319","article-title":"Randomized comparative study of efficacy and nephrotoxicity of ampicillin plus tobramycin versus cefotaxime in cirrhotics with severe infections","volume":"2013","author":"Felisart","year":"1985","journal-title":"Hepatology"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.20","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1111\/j.1572-0241.1999.01110.x","article-title":"Spontaneous bacterial peritonitis due to Pasteurella multicida without animal exposure","volume":"2013","author":"Beales","year":"1999","journal-title":"Am J Gastroenterol"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.21","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1111\/j.1572-0241.1998.00482.x","article-title":"Spontaneous bacterial peritonitis caused by infection with listeria monocytogenes: a case report and review of the literature","volume":"2013","author":"Jajaraj","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.22","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1056\/NEJM199908053410603","article-title":"Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis","volume":"2013","author":"Sort","year":"1999","journal-title":"N Engl J Med"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.23","doi-asserted-by":"crossref","first-page":"245","DOI":"10.2165\/00003495-199753020-00005","article-title":"Recognition and optimum treatment of brucellosis","volume":"2013","author":"Solera","year":"1997","journal-title":"Drugs"},{"key":"2025082800315502000_2013.apr05_1.bcr2013008629.24","first-page":"CD007179","article-title":"Antibiotics for treating human brucellosis","volume":"2013","author":"Yousefi-Nooraie","year":"2012","journal-title":"Cochrane Database Syst Rev"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-008629","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:32:04Z","timestamp":1756366324000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-008629"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,5]]},"references-count":24,"alternative-id":["10.1136\/bcr-2013-008629"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-008629","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,4,5]]}}}