A Rocky Resurgence

A 70-year-old woman presented with persistent right upper quadrant abdominal pain and systemic symptoms including fever, sweating, fatigue, and weight loss. Imaging and biopsy revealed a hepatic abscess with calcifications, and the patient’s history included travel to Albania—an endemic region for brucellosis. Initial cultures and serologic tests were negative, but molecular testing of liver tissue via 16S rRNA sequencing confirmed Brucella species. She was treated with antibiotics, transitioning from doxycycline to ciprofloxacin due to side effects, resulting in clinical improvement and resolution of the lesion. The case highlights diagnostic challenges and the value of molecular tools for endemic infections with atypical presentations.

A 70-year-old woman presented with persistent right upper quadrant abdominal pain and systemic symptoms including fever, sweating, fatigue, and weight loss. Imaging and biopsy revealed a hepatic abscess with calcifications, and the patient’s history included travel to Albania—an endemic region for brucellosis. Initial cultures and serologic tests were negative, but molecular testing of liver tissue via 16S rRNA sequencing confirmed Brucella species. She was treated with antibiotics, transitioning from doxycycline to ciprofloxacin due to side effects, resulting in clinical improvement and resolution of the lesion. The case highlights diagnostic challenges and the value of molecular tools for endemic infections with atypical presentations.