Unusual transverse colon perforation in an infant: a rare case of brucellosis-related peritonitis
Hanady Nabel Zwaraa, Mouhammed Sleiay, Lorieh Domat, Mohammed Alqreea, Aisha Tahsin Alkilani, Jean Domat, Iyass Ahmed Karfoul, Alaa Eid Alfarhan, Doha Mohammed AlhawarnhIntroduction:
Intestinal perforation is a rare but serious complication of brucellosis, especially in infants. Its diagnosis is challenging due to nonspecific symptoms and an unusual presentation.
Case presentation:
We report the case of an 8-month-old female who presented with high-grade fever, vomiting, irritability, and signs of peritonitis. Imaging revealed pneumoperitoneum. Emergency laparotomy showed a solitary perforation in the transverse colon. A primary two-layer repair with drainage was performed. Postoperative serology was positive for brucellosis (Wright test), while the Widal test was negative.
Clinical discussion:
Brucellosis in infancy is rare and is usually transmitted via maternal infection (placenta or breast milk) or, less commonly, through the ingestion of unpasteurized dairy products in endemic areas.
Conclusion:
Brucellosis should be considered in cases of intestinal perforation in endemic regions, even at atypical sites. Early recognition and combined surgical-medical treatment are crucial for favorable outcomes.