Case Report: Brucella Parotitis with Abscess Formation and Paradoxical Reaction on Therapy

In this report we describe a patient with sub-acute bacteremic brucellosis complicated by Brucella parotitis with abscess formation as a paradoxical reaction on therapy. A 69 years old male known to have Warthin’s tumor of parotid glands two years before his presentation. He presented with generalized ill-health, body-aches and feeling of further enlargement of his previous swellings at jaw angles for a few weeks. He admitted unpasteurized camels’ milk ingestion. Brucellosis was suspected and proven by a positive blood culture. 10 days after starting anti-brucellosis therapy, he reported back with bilateral parotid abscesses. Patient was diagnosed as sub-acute bacteremic brucellosis with brucella parotitis and abscess formation. The interval enlargement of parotid swellings and abscess formation 10 days after initiation of therapy is explained by paradoxical inflammatory reaction following response to therapy.