Case Wang, male, farmer, mainly sheep, with a clear history of contact with diseased animals (sheep) and experience of eating meat from diseased animals, had recurrent high fever over a period of one month, which was not completely effective despite antipyretic drugs, with a waveform fever pattern and a peak in the afternoon. The fever was accompanied by chills, profuse sweating and soreness of the bones and joints. Hematological examination showed a slightly low trigeminal system and normal liver function. Blood culture and bone marrow culture both found Brucella spp. and made a clear diagnosis. Brucellosis, as the name implies, is a rare acute and chronic infectious disease caused by Brucella infection in animals and humans, also known as “Malta fever”. The digestive tract infection. The average infection rate in the high-risk group is 1 per 1,000. Brucella can infect many hosts, including cats, dogs, pigs, rats, cattle (including cows and buffaloes), sheep and similar species. Humans can be infected through direct contact with diseased animals. Direct human-to-human contact, sexual intercourse and mother-to-child transmission, although very rare, still have the potential for transmission. Figure 1 Brucella, its route of infection in humans and the corresponding clinical manifestations Clinical manifestations of brucellosis are very atypical and its incubation period usually does not exceed 8 months. At the initial onset, Brucella causes symptoms that can resemble the flu, such as fever, malaise, and loss of appetite. If the appropriate antibiotics and antipyretics are taken, the condition will improve within a few weeks, but then similar symptoms will reappear. When the disease progresses to the acute stage (sepsis), the patient develops the classic triad of high fever with disorders of bones and joints and profuse sweating. The typical febrile pattern of the disease is a wave fever, in which the temperature rises above 39 degrees for a few days and then gradually decreases to normal levels over a few days, and so on. The peak temperature usually occurs in the afternoon and increases at night. Hematology tests may reveal a decrease in white blood cells, anemia, and mild increases in AST and ALT. Brucella can be found in blood bacteriological cultures taken at the time of temperature rise. Without any treatment, the disease may become limited or chronic. Localized lesions are usually located in bones and joints, with lumbar discitis with sacroiliac arthritis being the characteristic manifestation of the disease. The chronic course of the disease usually affects not only the bones, stomach, intestines, and lymph nodes, but can even lead to testicular swelling and prostate problems in men and frequent miscarriages in women due to damage to the uterus. Diagnosis 1. Blood cultures and bone marrow cultures find Brucella, but the organism grows extremely slowly and may take up to two months to identify. 2, detection of IgG and IgM antibodies against the bacterium, the method can be applied to the classic Huddleson, Wright and Bengal Rose staining reaction, or ELISA, 2-mercaptoethanol for detection. 3, Brucella genetic testing 4, histological evidence of hepatic granulomatous inflammatory changes found on liver biopsy 5, destruction of vertebrae with imaging manifestations of preferential invasion of the anterior upper part of the lumbar spine, typical lumbar spondylolisthesis may be a manifestation of Brucella-induced spondylolisthesis. The sequelae of this disease are diverse and include hepatic granulomatous inflammation, arthritis, spondylitis, anemia, granulocytopenia, thrombocytopenia, meningitis, optic neuritis, endocarditis, and neurological brucellosis. Antibiotics are preferred for treatment. Tetracyclines, rifampin, aminoglycoside streptomycin, and gentamicin, alone or in combination, are effective in killing Brucella. The standard treatment regimen is 1 g of streptomycin (gentamicin) intramuscularly for 14 consecutive days and 100 mg of doxycycline orally once every two days for 45 days. Another widely accepted regimen is doxycycline plus rifampin administered orally twice a day for at least six weeks. Triple therapy, doxycycline combined with rifampin and cotrimoxazole, has been widely used to treat neurologic brucellosis. Although antibiotics are effective in clearing the bacteria, the disease still recurs or worsens in 5-10% of patients. The mortality rate of this disease is less than 2%, and the most likely cause of death is brucellosis-induced endocarditis. During treatment, patients should rest in bed, eat a rich diet, take more vitamins and enhance immunity. Prevention should be done by washing hands regularly, keeping animals and livestock sanitation, preventing contamination of feed; drinking pasteurized dairy products and avoiding direct consumption of raw milk; avoiding direct skin exposure when working in farms, slaughterhouses and laboratories, and timely disinfection and immunization.