Abstract
RATIONALE: Ocular involvement is an uncommon but serious complication of brucellosis, often leading to diagnostic delays and potential vision loss. This report presents a case of brucellosis uveitis to raise clinical awareness and discusses its diagnosis and management. PATIENT CONCERNS: A 65-year-old female farmer presented with a 1-year history of intermittent fever and lower back pain, followed by progressive visual impairment and blurred vision over 2 months. DIAGNOSES: Based on the epidemiological history, serological tests that were positive for both the Rose Bengal plate test and the tube agglutination test, lumbar magnetic resonance imaging findings, and an ophthalmological examination, the patient was diagnosed with brucellosis accompanied by left ocular uveitis and optic nerve atrophy after other causes were excluded. INTERVENTIONS: The patient was treated with a systemic triple-antibiotic regimen (doxycycline, rifampicin, and compound sulfamethoxazole) for 3 months, alongside topical anti-inflammatory and antibiotic-steroid eye drops. OUTCOMES: After 2 months of treatment, the uveitis had resolved significantly, and visual acuity was restored to 1.0 in both eyes. The patient remained asymptomatic at 1-year follow-up. LESSONS: This case underscores the importance of considering brucellosis in the differential diagnosis of uveitis, especially in endemic areas. A combination of serology, imaging, and specialist examination is crucial for timely diagnosis and prevention of irreversible ocular damage.