Robby

He eventually, on day four or five of treatment, turned a corner and everything just got better pretty quickly.

Everything, sort of all the symptoms went away.

He gained a weight back and was doing much better.

So the diagnosis was brucellosis, thought to be acquired from eating unpasteurized dairy products in the home country.

And by the way, just to also reveal, this case was sort of told from the perspective of my dad's friend.

And the 19-year-old person was me 20-some years ago.

And yeah, the only sort of changed feature of the case was that it was Armenia, not Greece.

But I made sure that the epidemiology was nearly equivalent in the two countries before picking Greece.

Yeah.

So, no, I've been wanting to share this case for a while just because it was obviously personal and very interesting.

And it was a very difficult diagnostic journey for, you know, for everybody and just had.

But no, this is I had a very classic case.

So 80 percent of patients with brucellosis have a systemic illness characterized by all three of those kind of cardinal symptoms, like the so-called undulating fever, sort of very stereotyped daily.

migratory oligoarthritis very much like this, and then night sweats, which again sort of flew under the radar as a symptom because of what I described.

I just sort of didn't think anything of it.

But in retrospect, they even had the typical sort of musty smell that it was just very, very unusual.

And then some of those other sort of peripheral mucocutaneous and like the weight loss and ulcers and the weird subcutaneous nodules, they happen.

I don't exactly understand why.

But to your point, Reza, it can very much also present as a focal disease.

So the most common like focal site of illness other than the arthritis, which is thought to be both like actual septic arthritis and potentially sort of immunologic reactivity is the spine.