In his family history, it was stated that two months later, he had lost
his wife, and he presented with extreme fatigue and malaise. His
children thought he was depressed.
Further history was gained, and it was found the patient had consumed
raw milk from a dairy farm. On further questioning, the patient admitted
to a history of brucellosis eight years ago. The patient also endorsed
previously returned brucella symptoms that had happened over the
previous months.
A follow-up serology (IgM/IgG) showed a positive brucella titer
of 1:160 for wright [and Brucella coombs-wright 1:160, 2ME- wright
(IgG) titer 1:40] and the patient was diagnosed with active
brucellosis. He was started on a combination of doxycycline 100 mg and
rifampicin 600 mg once daily for six days in addition to anti-COVID-19
treatment (mini pulse of prednisolone, and dexamethasone 10 mg/ 12 h for
4 days, then 10 mg/ day for another 5 days. On the
16th day of hospitalization, his P O2 was measured at
90% without ventilation, leukopenia improved completely, At the time of
discharge, his respiratory symptoms had got better and the second
SARS-COV-2 RNA test was negative. Since there is the first co-infection
of brucellosis with COVID-19 in our region, this specific old patient in
our case has been presented.