Brucellosis — SCE Infectious Diseases MCQ

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ModerateTropical & Imported InfectionsBrucellosisSCE Infectious Diseases

A 45-year-old man with no significant history presents with a 3-week history of fever, night sweats, and hepatosplenomegaly. He keeps exotic reptiles. Blood cultures at 5 days grow a slow-growing Gram-negative coccobacillus that is oxidase-positive and urease-positive. What is the most likely diagnosis?

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Correct answer: D — Brucellosis

Slow-growing Gram-negative coccobacillus that is oxidase-positive and urease-positive with fever, hepatosplenomegaly, and animal contact is consistent with Brucella species. While classically associated with unpasteurised dairy and farm animals, exotic reptile keeping is an emerging risk factor. Blood cultures may take 5–7 days to become positive. The microbiology laboratory must be informed of the suspicion as Brucella is a hazard group 3 organism requiring containment. Treatment is Doxycycline plus Rifampicin for 6 weeks.

Reference: WHO 2020 – Brucellosis; UKHSA 2023 – Brucellosis guidance