A 52-year-old female patient was referred to the Infectious Diseases Department of the Faculty of Medicine Ankara University with complaints of fatigue, arthralgias, fever, and 10 kg weight loss over two months before admission. At the time of hospitalization, her vital parameters were body temperature: 38.0 C, blood pressure: 100/80mm/Hg, heart rate: 88 bpm, and respiratory rate: 22 bpm. Lung auscultation revealed decreased respiratory sounds in both lower lobes. Chest radiography showed bilateral pleural effusions and diffuse infiltrative opacities in the bases of both lungs. Her physical examination showed a palpable mass in the liver 4 cm below the right costal margin, along the midclavicular line. The spleen was not palpable but with percussion splenomegaly could be determined. No abnormal physical examination finding was present in the other systems. On laboratory findings serum transaminase levels were two times higher than the upper limits of normal; she had a mild leucopenia and an elevated CRP level (see Table 1). After blood cultures were performed from both arms, empiric 2 g ceftriaxone twice daily intravenously and clarithromycin 1 gm twice daily orally was started because of a suspected respiratory tract infection. In the following days the patient's fever had subsided. Abdominal ultrasound revealed hepatosplenomegaly, sludge in the gallbladder, intrahepatic venous congestion, and multiple hypodense splenic lesions (the largest one was 1 cm in diameter). Thoracic CT scan showed bilateral pleural effusions and atelectasis in adjacent lung zones. A subpleural nodular opacity was detected in the right apical segment, and peribronchovascular interstitial thickening was seen in the right lower lobe. On the basis of these findings, ultrasound-guided thoracentesis was planned, but the patient refused any invasive procedure. 
 Brucella melitensis was isolated from the blood cultures obtained at the time of hospitalization, on the fourth day of incubation. The antibiotic therapy was switched from ceftriaxone and clarithromycin to oral rifampicin 600 mg/day and doxycycline 200 mg/day. The Brucella isolate was sent to a reference laboratory, and it was reported as Brucella melitensis biotype 3. The titers of brucellosis antibodies were measured as 1 : 640 (seropositive) using the standard tube agglutination test. The patient had no history of contact with animals, consuming fresh cheese or milk, but she had a history of eating raw meatballs (a traditional Turkish food which is made with raw meat and pounded wheat) two months before admission.
The patient was reevaluated for a suspected brucella endocarditis, but her cardiac examination and transthoracic echocardiography was normal. Because she also had a complaint of mild back pain, thoracolumbar MRI was performed without pathology seen. 
Fifteen days after the initial course of brucellosis treatment, no pleural effusion or pulmonary consolidation was seen on the follow-up chest radiography and ultrasonography. At the end of the 24th day abdominal ultrasonography was repeated. Splenic lesions and hepatosplenomegaly were totally regressed, and a normal gallbladder was seen. Brucellosis was expected to be the cause of all pathological signs that were previously seen in the lungs and abdomen, and the regression of these was assumed as a response to the therapy. 
The patient was discharged in good health after a 32-day hospital stay. She completed a 6-week drug regimen at home. During this time all her complaints have resolved. She has been followed for 3 months after the end of therapy without recurrence.