December 12, 2024 VMR with Rabih & Johann - myalgia and muscle weakness

[@EsfandiarShojaei]

Thank you for sharing this fantastic case. I’d like to add that due to the prozone effect, where very high concentrations of antibodies interfere with antigen-antibody complex formation, false-negative results in Brucella serology are possible. Brucella can be identified using MALDI-TOF early in the course of microbiologic evaluation. However, if conventional culture methods are used, it is essential to keep the culture for an extended period rather than reporting it as negative after 48-72 hours. Additionally, PCR evaluation of bone marrow for Brucella could also be helpful.