There are 500,000 cases of brucellosis reported worldwide annually. The disease is endemic to the Mediterranean basin, Central Asia, China, sub-Saharan Africa, and parts of Mexico and Central and South America. As Brucella species are considered zoonotic bacteria, person-to-person infections are rare and clustering of cases may represent a more widespread problem in domesticated animal infections. In the US, 100-200 cases of human brucellosis are reported annually.

Studies indicated brucellosis is associated with chronic debilitating infections humans. Clinically, an infected individual’s signs and symptoms consist of an influenza-like illness with an insidious onset. Because of the misleading clinical picture, less than 10% of human cases of brucellosis are recognized and reported. Historically, lack of standardized therapy in the acute phase has resulted in bacterial infections localizing to various tissues, leading to subacute or chronic disease with serious implications.

We present a 71-year-old woman arriving to the emergency department immediately from the airport after a flight from Guatemala. She had a persistent fever and had been receiving treatment in Guatemala for the past week.