Background
Brucellosis is one of the most common zoonotic diseases worldwide,
especially in Asia and Middle Eastern countries such as Iran
[1,2,3], which is transmitted to humans through the consumption of
unpasteurized dairy products and direct contact with infected animal
tissues [4,5,6]. It has been demonstrated that brucellosis can
involve any part of the body including the musculoskeletal system,
genital organs, gastrointestinal system, nervous system, respiratory
system, circulatory system, skin, heart, liver, spleen, bone, kidney,
brain, epididymis, ovary, and gallbladder [7,8,9] and it causes a
systemic infection from asymptomatic disease to fatal illness
[10,11] and it can mimic other infectious and non-infectious
diseases [4,12]. So it is known as a “great imitator” [10].
The onset of the disease can be insidious and when specific organ
involvement is detected it is defined as focal brucellosis
[2,10,11]. In addition, arthritis, spondylitis, endocarditis,
meningitis, orchitis due to brucellosis are not uncommon [10,11,13];
but cutaneous and subcutaneous involvement with brucellosis are uncommon
[14]. Although soft tissue locations are usually related to a
penetrating injury, the hematogenous spread is considered an important
pathologic route [8,13,15].
Although breast infection with granulomatous mastitis is described in
animals, infection of mammary glands with brucella is extremely rare in
human brucellosis [13,14,15]. Brucella-infected mammary glands have
been reported in a few cases and it is often hematogenous such as a
metastatic abscess in endocarditis [11]. In one case I. Gasser et
al. reported the isolation of Brucella melitensis from a suspected
breast tumor of a woman who also had uveitis [13].
Osteoarticular lesions which are the most common complications in
brucellosis include peripheral arthritis, osteomyelitis, spondylitis,
sacroiliitis, and bursitis. Common joints consist of the knee, hip,
ankle, and sacroiliac and less frequent ones include the shoulder,
sternoclavicular, and temporomandibular [10,11,16,17].