Chronic Splenic Brucellosis: CT Diagnosis, Imaging Interpretation, Pathophysiology, and AI-Assisted Clinical Decision Making
Clinical Hook Imagine evaluating an 84-year-old man who arrives at the emergency department with fever, shortness of breath, and newly developed confusion. At first glance, these symptoms suggest pneumonia, sepsis, or even stroke. Physical examination reveals no remarkable findings, and there is no obvious source of infection. Then an abdominal contrast-enhanced CT unexpectedly reveals a coarsely calcified lesion within the spleen . Most clinicians would initially consider healed granulomatous disease, old trauma, splenic infarction, or calcified neoplasm. Few would immediately suspect brucellosis , especially in a patient whose occupational exposure occurred more than five decades earlier. However, blood cultures ultimately identify Brucella suis , confirming reactivation of chronic splenic brucellosis. This remarkable case demonstrates that zoonotic infections can persist silently for decades before becoming clinically apparent. For radiologists, infectious disease specialists,...
