Patient 3. A 40-year-old diabetic patient was admitted with severe cellulitis of the feet after walking bare-footed on the sand. His diabetes is poorly controlled with HBA1C 15.5 (mmol/mol). His course was complicated by neuropathy and retinopathy. He also admitted to (R) knee swelling of two years duration. Multiple aspirations and injections of the knee resulted in temporary relief. There was no history of fever or night sweats. He had contact with animals but did not consume raw milk. The (R) knee was swollen, hot, and tender with restricted range of movement. Admission WBC was 8.7, CRP 38 mg/mL, albumin 24 g/dL, and alkaline phosphatase 220 mu/L. CT scan showed moderate to large effusion of the right knee with associated synovial thickening and osteoarthritic changes (Figure 4). Synovial fluid showed WBC of 9.9 x 109 with 50.5% polymorphs. AFB smears and PCR for tuberculosis were negative. Synovial cultures isolated Brucella species but blood culture was negative. Brucella serology in the blood was high; it was 1 : 10240 and dropped to 1 : 640 on treatment. He received two weeks of streptomycin and completed a 3-month course of rifampicin and doxycycline.