Brucellosis mimicking Henoch–Schönlein purpura

A young male immigrant from Syria with a vasculitic-appearing leg rash, asymmetrical polyarthritis, microscopic haematuria, and raised inflammatory markers was provisionally diagnosed with Henoch–Schönlein purpura. Skin biopsy showed leukocytoclastic vasculitis. Low-grade fevers persisted despite non-steroidal anti-inflammatory therapy, and Brucella sp. was subsequently grown from both blood and synovial fluid aspirates. Further tests gave positive results for B. abortus, and triple antibiotic therapy produced a rapid clinical response. Cutaneous vasculitis has rarely been described in brucellosis, and this is the first report in the English medical literature of brucellosis mimicking Henoch–Schönlein purpura.

A 22-year-old man presented with arthralgia, fevers, weight loss and a leg rash. His medical history was unremarkable, and he was taking no medications. He had emigrated from Syria 2 months before to be with his family in Australia. He had been sexually active before emigration, but did not describe any illness consistent with a sexually transmitted disease.