fa گزارش یک مورد آبسه بافت نرم در ناحیه خلفی ساق پا به‌عنوان یکی از تظاهرات نادر بروسلوز پزشکی -عفونی Medicine - Infectious گزارش مورد case report <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.1pt">زمینه</span></span></span></span></span></span></b><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.1pt">&nbsp;و هدف:</span></span></span></span></span></span></b>&nbsp;<span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">بروسلوزیس از شایع‌ترین بیماری‌های زئونوز در مناطق آندمیک است که می‌تواند طیف</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">وسیعی</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">از</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">تظاهرات</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">بالینی، از</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">علائم</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">عمومی</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">تا</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">درگیری</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ارگان‌های</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">مختلف، ازجمله استخوان و مفصل ایجاد</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">کند. آبسه‌های</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">بافت</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">نرم</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">به‌عنوان</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">یکی</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">از</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">تظاهرات</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">بروسلوزیس، بسیار</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">نادر</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">گزارش‌ شده‌اند</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">و</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">می‌توانند</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">روند</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">تشخیص</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">را</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">به</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">تأخیر</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">بیندازند.</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3">گزارش مورد:</span></span></span></b> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">در این گزارش، بیماری </span></span><span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">۳۹</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> ساله، دامدار و ساکن روستا معرفی می‌شود که با تورم و درد پیش‌رونده در ناحیه خلفی ساق پا مراجعه کرد. در معاینه بالینی، تورم دردناک همراه با گرمی مشاهده شد. آزمایش‌های آزمایشگاهی نشان‌دهنده لنفوسیتوز نسبی و افزایش شاخص‌های التهابی (</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">ESR</span></span><span style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> و</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">CRP </span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) بود. تست‌های سرولوژیک (رایت، کومبس رایت و</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">2ME </span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) مثبت و به نفع بروسلوزیس فعال بودند. در بررسی ام‌آر‌آی، کالکشن مایع با حاشیه مشخص در کمپارتمان خلفی ساق پا دیده شد که با آبسه داخل‌عضلانی سازگار بود. آسپیراسیون ضایعه وجود گونه </span></span><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Brucella</span></span></i><i> </i><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">را تأیید کرد. بیمار</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">با</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">رژیم</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">سه‌گانه،</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">شامل</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">داکسی</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">‌</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">سایکلین،</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ریفامپین</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">و</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">جنتامایسین، تحت</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">درمان قرار</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">گرفت</span></span><span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> و </span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">درمان</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ترکیبی</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">پس</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">از</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ترخیص</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">به‌مدت</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">هشت</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">هفته</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ادامه</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">یافت. در پیگیری دو ماه بعد، بیمار بهبودی کامل بالینی و کاهش تیترهای سرولوژیک داشت.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3">نتیجه‌گیری:</span></span></span></b> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">این گزارش اهمیت توجه به بروسلوزیس را به‌عنوان تشخیص افتراقی در بیماران مبتلابه آبسه‌های غیرمعمول بافت نرم، به‌ویژه در مناطق آندمیک، نشان می‌دهد.</span></span></span></span></span></span></span> <span style="font-size:12pt"><span style="line-height:95%"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="line-height:95%"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:.15pt">Background and Aim:</span></span></span></span></span></b> <span style="font-size:9.0pt"><span style="line-height:95%"><span style="font-family:Optima">Brucellosis is one of the most prevalent zoonotic infections in endemic regions, presenting with a wide spectrum of clinical features, ranging from nonspecific systemic symptoms to multi-organ involvement, most commonly affecting the osteoarticular system. Soft tissue abscesses are a rare presentation of brucellosis and may delay diagnosis.</span></span></span><br> <b><span style="font-size:9.0pt"><span style="line-height:95%"><span style="font-family:Optima"><span style="color:#274cc3">Case Presentation</span></span></span></span></b><span style="font-size:9.0pt"><span style="line-height:95%"><span style="font-family:Optima"><span style="color:#274cc3">:</span></span></span></span><span style="font-size:9.0pt"><span style="line-height:95%"><span style="font-family:Optima"> We present the case of a 39-year-old male livestock farmer from a rural area who developed progressive pain and swelling in the posterior aspect of the left calf. Physical examination revealed a tender, warm swelling. Laboratory investigations showed relative lymphocytosis and elevated inflammatory markers, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Serological tests, including Wright, Coombs Wright, and 2-mercaptoethanol (2ME) tests, were strongly positive, consistent with active brucellosis. Magnetic resonance imaging revealed a well-defined fluid collection in the posterior compartment of the calf, consistent with an intramuscular abscess. Aspiration of the lesion confirmed the presence of Brucella species. The patient was treated with a three-drug regimen of doxycycline, rifampin, and gentamicin, followed by an extended eight-week oral regimen of doxycycline and rifampin. At the two-month follow-up, the patient had achieved complete clinical recovery, with normalization of serological titers.</span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:95%"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="line-height:95%"><span style="font-family:Optima"><span style="color:#274cc3">Conclusion:</span></span></span></span></b><span style="font-size:9.0pt"><span style="line-height:95%"><span style="font-family:Optima"> This case highlights the importance of considering brucellosis in the differential diagnosis of unusual soft tissue abscesses, particularly in endemic areas.</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:95%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span> بروسلوزیس, آبسه بافت نرم, ساق پا Brucellosis, Calf, Soft tissue abscess 21 30 http://sjku.muk.ac.ir/browse.php?a_code=A-10-7145-1&slc_lang=fa&sid=1 Gohar Lotfi گوهر لطفی glotfi12340@gmail.com 5400319475328460074556 5400319475328460074556 Yes Assistant Professor, Department of Infectious Diseases, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran استادیار, گروه عفونی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران