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To the Editor:—
In The Journal, Jan. 14, there is a question and answer on hydrarthrosis, and brucellosis, a known possible cause of hydrarthrosis, was not mentioned.In some cases Brucella has been isolated from the synovial fluid. In others the fluid has been sterile but the effusion has yielded to treatment of the brucellosis (Harris, H. J.: Brucellosis [Undu-lant Fever]—Clinical and Subclinical, ed. 2, New York: Paul B. Hoeber, Inc., 1950, pp. 214-216). Hydrarthrosis often occurs, after only trivial injury to the joints in patients suffering from chronic, low-grade brucellosis.In attempting to establish the diagnosis of brucellosis, all available tests should be used. One should not rely on the agglutination test alone unless it is positive in high titer. About 50 per cent of cases of chronic brucellosis show no agglutinins or agglutinins in low titer only. In these instances one must depend on additional information furnished
Harris HJ. Brucellosis, a Possible Cause of Hydrarthrosis. JAMA. 1961;176(4):390–391. doi:10.1001/jama.1961.03040170136031
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