Background and Aims:This study aims to examine the prevalence and progression of coagulation disorders in adult COVID-19 patients and evaluate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on coagulation markers. Methods:This retrospective study included 1885 hospitalized COVID-19 patients, aged 20 to over 90 years, from January 23, 2020, to March 9, 2021, across 23 centers in 13 provinces in Iran. Patients were categorized into three epidemiological peaks corresponding to different pandemic waves and SARS-CoV-2 variants (wild-type, B.1.36, and B.1.1.413). Data collection and statistical analysis adhered to the Iranian Center for Disease Control guidelines, with laboratory assessments focusing on hematologic and coagulation markers, including prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet (PLT) count, and Hemoglobin (Hb). Parameters were assessed to monitor coagulation dynamics and thrombotic risk over time and across epidemic waves. Estimated marginal means enabled evaluation of biomarker fluctuations by time and sex. Results:The majority of patients were below 70 years of age, with hypertension and diabetes as common underlying conditions. The study revealed a trend of increasing white blood cells, neutrophils, neutrophil-to-lymphocyte ratio, and PLTs during the initial week. Conversely, hemoglobin and lymphocytes exhibited a downward trend. PLT, lymphocyte, and neutrophil levels were not significantly affected by sex, age groups, or different peaks. Notably, hospitalized patients exhibited prolonged PT and aPTT. Overall, 81.1% of patients recovered, while 18.9% succumbed to the disease. Conclusion:This multicenter study provides valuable insights into the coagulation dynamics of COVID-19 patients, highlighting specific coagulation disorders associated with SARS-CoV-2. The findings emphasize the importance of monitoring coagulation markers for effective patient management and treatment decisions. Understanding how genetic and non-genetic factors influence outcomes is crucial for comprehensive care. Standardized data collection across centers strengthens the study's reliability.

ABSTRACT A 42‐year‐old male amateur football player presented with a 17‐day history of progressive groin pain, primarily on the right, radiating to the perineum, associated with limitation of hip motion. Because of proximal weakness and elevated inflammatory markers, polymyositis and an infectious process were initially suspected. Electromyography demonstrated a subacute incomplete axonal lesion of the right femoral nerve likely due to iliopsoas compression. Joint aspiration yielded purulent‐appearing fluid with 850 WBC/mm3 and 80% PMNs, although cultures remained negative. MRI demonstrated bone marrow edema at the pubic symphysis, fluid collections in the adductor and iliacus muscles, right iliopsoas bursitis, and mild hip effusion, supporting a diagnosis of osteitis pubis with associated inflammatory myositis and bursitis rather than primary infection or polymyositis. Empirical antibiotics and corticosteroid therapy resulted in clinical and laboratory improvement. This case highlights the diagnostic challenge of osteitis pubis presenting with femoral neuropathy and inflammatory findings that may mimic infectious or inflammatory myopathy.

Neurobrucellosis with psychiatric manifestations is an uncommon manifestation of brucellosis. Herein, we report a 31-year-old male complaining of dizziness, nausea, malaise, imbalance, amnesia, psychosis, delusion, and impulsive and disorganized behavior. He was not responsive to antipsychotic treatment, and his brain MRI showed demyelinating hyperintensity foci in the periventricular and paraventricular areas and the subcortical areas of the right temporal and frontal lobes. His serum and cerebrospinal fluid serology were in favor of brucellosis, and he dramatically responded to anti-Brucella medications. Although demyelinating neurobrucellosis with psychiatric manifestations is rare, it should be suspected in unresponsive patients coming from brucellosis-endemic areas.

Introduction: Fluoroquinolone (FQ) and co-trimoxazole (STX) are the most effective antibiotics for Escherichia coli; however, antibiotic resistance has become an ever-increasing challenge. The current study investigates the prevalence rate and risk factors for developing FQ and STX resistance in Northwest Iran. Methods: This is a retrospective cohort study of 314 patients admitted to Sina Hospital, the academic hospital affiliated with Tabriz University of Medical Sciences, Iran, between 21st March 2017 to 20th March 2018. Based on specimen culture, patients were divided into two groups, i.e., FQ or SXT-resistant E. coli and the antibiotics sensitive. The potential risk factors for developing FQ or SXT-resistant E. coli were studied in the included patients. Results: FQ and SXT-resistant E. coli prevalence was 66.3% and 70%, respectively. Univariate analyses showed that type II diabetes mellitus, prior antibiotic use, prior FQ administration, prior admission, prior urinary tract infection, urinary catheterization, and anemia were the significant risk factors for developing FQ-resistant E. coli infection. The univariate analyses indicated that prior antibiotic use, hospitalization in an intensive care unit (ICU), and urinary catheterization were the significant risk factors for developing SXT-resistant E. coli infection. FQ and SXT-resistant E. coli infections are prevalent in our region. Prior antibiotic use and urinary catheterization are the common risk factors for developing FQ and SXT-resistant E. coli in our region. Conclusion: Type II diabetes mellitus, prior urinary tract infection, gentamicin resistance, prior FQ administration, and extended-spectrum β-lactamases (ESBL) production are risk factors for developing FQ-resistant E. coli and ESBL production is the risk factor for developing STX-resistant E. coli in our region.

Background: The envelope (E) protein of globally circulating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly conserved. This study aimed to find the mutation rate of the E genes in COVID-19 patients, and also to evaluate the conformational characteristics of viral E protein. Methods: In this study, 120 patients with SARS-CoV-2 positive test results were selected according to real-time PCR assay. Specific primers for conventional PCR have been used to amplify E gene; furthermore, to identify the E gene mutations, direct sequencing of the E genes was also done. Bioinformatics techniques were used to investigate the possible effects of antigenic changes and 3D characteristics of amino acid substitutions. Also, the immunogenicity of wild-type and mutant E was analyzed utilizing a ClusPro docking server and the IEDB online platform. Results: A total of 120 COVID-19 patients were included (57.5% were male and 42.5% female), with an overall mean age of 55.70 +/- 10.61 years old. Of 10 nucleotide changes, 8 (80%) were silent. Also, 2 (20%) missense mutations (amino acid altering) were found in the E gene (L73F and S68F). Conclusion: These mutations insert some new helix structures in the E mutants. Also, the results of molecular docking studies indicated that both S68F and L73F mutations could notably enhance the stability and binding affinity of protein E's C-terminal motif to the Protein Associated with LIN7 1, MAGUK P55 Family Member (PALS1) which may probably increase local viral spread, and infiltration of immune cells into lung alveolar spaces.

Background Microsporidia and Cryptosporidium are obligate intracellular protozoa. These medically important species are recognized as opportunistic organisms in intestinal complications in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome patients.Methods The current cross-sectional study was designed and conducted from August 2016 to August 2017 to determine intestinal Cryptosporidium and microsporidia spp. in HIV-infected individuals from the Behavioral Diseases Counseling Center, Tabriz, Iran, by modified acid-fast and modified trichrome staining and nested polymerase chain reaction (PCR) and real-time PCR.Results Of 100 HIV-infected persons, 21.0% (95% confidence interval [CI] 13.0 to 30.0) and 18.0% (95% CI 11.0 to 26.0) were identified as Cryptosporidium and microsporidia, respectively, by the microscopic method. Of these 100 HIV-infected persons, 18.0% (95% CI 11.0 to 26.0) and 14.0% (95% CI 7.0 to 22.0) were positive for Cryptosporidium and microsporidia, respectively, by the molecular method. The predominant species of microsporidia in patients was Enterocytozoon bieneusi (85.7% [95% CI 57.0 to 98.0]) and Encephalitozoon cuniculi (14.3% [95% CI 1.7 to 42.0]), which were found by quantitative real-time PCR and its high-resolution melting tool.Conclusions As far as we know, this study is the first to estimate the prevalence of infection with Cryptosporidium and microsporidia among HIV-infected persons in northwest of Iran. The prevalence of intestinal microsporidiosis and cryptosporidiosis in this area in HIV-infected people was higher than the global prevalence of infection among immunocompromised patients. In addition to the need for further studies to prove protozoan pathogenicity in the aforementioned group, preventive measures should be considered.

To evaluate the demographic, clinical, and prognostic characteristics of patients diagnosed with COVID-19-associated mucormycosis (CAM) in Iranian patients. This prospective observational study was conducted in 8 tertiary referral ophthalmology centers in different provinces of Iran during the fifth wave of the COVID-19 pandemic. All patients were subjected to complete history taking and comprehensive ophthalmological examination and underwent standard accepted treatment strategy based on the disease stage. Two hundred seventy-four CAM patients (most were males (150, 54.7

INTRODUCTION:Vitamin A is one of the vitamins that is suggested as adjuvant therapy in viral infections due to its immune enhancing role. In the present clinical trial, we intended to assess the effect of vitamin A supplementation on Coronavirus disease-2019 (COVID-19) in hospitalized patients. METHODS:The present pilot randomized controlled clinical trial was conducted on 30 hospitalized patients with COVID-19. Patients in the intervention group received 50000 IU/day intramuscular vitamin A for a maximum of two weeks. Patients in the control group continued their common treatment protocols. All participants were followed up until discharge from the hospital or death. The primary outcome of the study was time to achieve clinical response based on the six classes of an ordinal scale. Time to clinical response was calculated based on the days needed to improve two scores on the scale or patient's discharge. RESULTS:The time to clinical response was not significantly different between the two groups (7.23 ± 2.14 vs. 6.75 ± 1.85 days, respectively, p = 0.48). There was no significant difference between the groups regarding clinical response (hazard ratio: 1.76 [95% CI: 0.73, 4.26]). There were no significant differences between groups regarding the need for mechanical ventilation, duration of hospitalization, or death in the hospital. CONCLUSION:The results of this pilot clinical trial showed no benefit of vitamin A compared with the common treatment on outcome severity in hospitalized patients with COVID-19. Although the results are negative, there is still a great need for future clinical studies to provide a higher level of evidence.

Background: Application of electromembrane extraction coupled with capillary electrophoresis was studied for ofloxacin extraction from plasma samples. Methods: Ofloxacin migrated from acidic plasma samples through a thin layer of 1-octanol immobilized in the pores of a porous hollow fiber wall into a 10 µL acidic aqueous acceptor solution located inside the lumen of the fiber. Results: Under optimum conditions influencing electromigration (i.e., 20 min of the operation time, stirring speed of 750 rpm, donor phase pH at 4.0, acceptor pH at 3.0, and applied voltage of 30 V across the supported liquid membrane), ofloxacin was extracted from plasma samples with an enrichment factor of 100-fold corresponding to extraction percent of 24%. The calibration curve showed acceptable linearity in the range of 0.2-7.0 µg.mL-1 (R=0.9993). The limits of detection and quantification of 0.05 and 0.2 µg.mL-1 were obtained, respectively. The inter- and intra-day precision and accuracy were obtained below 8.65%. Conclusion: The validated method was successfully processed for the ofloxacin determination in the plasma samples of patients under ofloxacin therapy. There were no interfering peaks which indicates the great selectivity of the developed method.

The emergence of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global pandemic. Concurrently, reports of mucormycosis cases surged, particularly during the second wave in India. This study aims to investigate mortality factors in COVID-19-associated mucormycosis (CAM) cases, exploring clinical, demographic, and therapeutic variables across mostly Asian and partly African countries. A retrospective, cross-sectional analysis of CAM patients from 22 medical centers across eight countries was conducted, focusing on the first 3 months post-COVID-19 diagnosis. Data collected through the ID-IRI included demographics, comorbidities, treatments, and outcomes. A total of 162 CAM patients were included. The mean age was 54.29 +/- 13.04 years, with 54% male. Diabetes mellitus (85%) was prevalent, and 91% had rhino-orbital-cerebral mucormycosis. Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age (hazard ratio [HR] = 1.06, [P < .001]), rituximab use (HR = 21.2, P = .05), and diabetic ketoacidosis (HR = 3.58, P = .009) identified as risk factors. The mortality risk increases by approximately 5.6% for each additional year of age. Surgical debridement based on organ involvement correlated with higher survival (HR = 8.81, P < .001). The utilization of rituximab and diabetic ketoacidosis, along with advancing age, has been associated with an increased risk of mortality in CAM patients. A combination of antifungal treatment and surgical intervention has demonstrated a substantial improvement in survival outcomes.

Uropathogenic Escherichia coli (UPEC) are the strains diverted from the intestinal status and account mainly for uropathogenicity. This pathotype has gained specifications in structure and virulence to turn into a competent uropathogenic organism. Biofilm formation and antibiotic resistance play an important role in the organism's persistence in the urinary tract. Increased consumption of carbapenem prescribed for multidrug-resistant (MDR) and Extended-spectrum-beta lactamase (ESBL)-producing UPECs, has added to the expansion of resistance. The World Health Organization (WHO) and Centre for Disease Control (CDC) placed the Carbapenem-resistant Enterobacteriaceae (CRE) on their treatment priority lists. Understanding both patterns of pathogenicity, and multiple drug resistance may provide guidance for the rational use of anti-bacterial agents in the clinic. Developing an effective vaccine, adherence-inhibiting compounds, cranberry juice, and probiotics are non-antibiotical approaches proposed for the treatment of drug-resistant UTIs. We aimed to review the distinguishing characteristics, current therapeutic options and promising non-antibiotical approaches against ESBL-producing and CRE UPECs.

Objectives: This study was conducted to collect evidence that specified the role of demographic findings (emphasizing age) and systemic inflammatory indicators in the coronavirus disease 2019 (COVID-19) and the outcome of disease which could help clinicians to predict mortality and intensive care unit (ICU) admission of COVID-19 patients. Design: A retrospective cohort study. Setting (s): Tabriz, the capital city of the East Azerbaijan Province in northwestern Iran. Participants: This retrospective cohort study involved analyzing the medical records of 311 COVID-19 patients from 22 July, 2020 to 22 August, 2020. Outcome measures: The demographic, clinical, and laboratory data and outcomes such as death, ICU admission, and discharge were extracted from medical records and electronic case records. Results: The analysis of collected data revealed that the average age of non-survivor patients was 68.53±14.68 which was significantly higher than that of survivor patients (59.30±16.44). Furthermore, the comparison of data showed that ischemic heart disease (IHD), respiratory diseases, hemoglobin, derived neutrophil-to-lymphocyte ratio (dNLR), NLR, platelet-to-lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) were higher in non-survivors and ICU admitted patients than in survivors and non-ICU admitted patients. Moreover, multivariate logistic regression analysis indicated that only hypertension (Odds ratio [OR]: 3.18, P=0.02) is an independent risk factor of death in COVID-19 patients, and PLR (OR: 1.02, P=0.05), hypertension (OR: 4.00, P=0.002), and IHD (OR: 5.15, P=0.008) were independent risk factor of ICU admission in COVID-19 patients. Conclusions: Elderly patients were at higher risk of death and ICU admission compared to others. Further, demographic characteristics and systemic inflammatory indicators were valuable factors for predicting mortality and ICU admission of COVID-19 patients. Collective data regarding the role of demographic characteristics and systemic inflammation indicators for predicting disease outcomes provide strong evidence for the clinical use of these indicators prospectively.

Breath analysis is an effective method of monitoring systemic or respiratory ailments. A simple chiral capillary electrophoresis method coupled with an online field-amplified sample injection stacking method is presented for ultratrace quantification of the enantiomers of ofloxacin in exhaled breath condensate (EBC). The study is focused on the use of EBC as an easily available biological sample to monitor ofloxacin's enantiomers levels with good patient compliance. The proposed method was validated in accordance with FDA guidelines over the concentration range of 0.004-1.0 mu g mL-1 of racemic ofloxacin. Inter-and intra-day precision and accuracy were within the acceptable limit (below 8.50 %). The method was specific for routine analysis of ofloxacin's enan-tiomers. A small volume of EBC samples from seven patients under ofloxacin therapy was analyzed using the proposed method in which the concentrations of "R" and "S" enantiomers were between 0.0026 and 0.056 mu g mL- 1.

BACKGROUND:Global real-time monitoring of SARS-CoV-2 variants is crucial to controlling the COVID-19 outbreak. The purpose of this study was to set up a Sanger-based platform for massive SARS-CoV-2 variant tracking in laboratories in low-resource settings.METHODS:We used nested RT-PCR assay, Sanger sequencing and lineage assignment for 930-bp of the SARS-CoV-2 spike gene, which harbors specific variants of concern (VOCs) mutations. We set up our platform by comparing its results with whole genome sequencing (WGS) data on 137 SARS-CoV-2 positive samples. Then, we applied it on 1028 samples from March-September 2021.RESULTS:In total, 125 out of 137 samples showed 91.24% concordance in mutation detection. In lineage assignment, 123 out of 137 samples demonstrated 89.78% concordance, 65 of which were assigned as VOCs and showed 100% concordance. Of 1028 samples screened by our in-house method, 78 distinct mutations were detected. The most common mutations were: S:D614G (21.91%), S:P681R (12.19%), S:L452R (12.15%), S:T478K (12.15%), S:N501Y (8.91%), S:A570D (8.89%), S:P681H (8.89%), S:T716I (8.74%), S:L699I (3.50%) and S:S477N (0.28%). Of 1028 samples, 980 were attributed as VOCs, which include the Delta (B.1.617.2) and Alpha (B.1.1.7) variants.CONCLUSION:Our proposed in-house Sanger-based assay for SARS-CoV-2 lineage assignment is an accessible strategy in countries with poor infrastructure facilities. It can be applied in the rapid tracking of SARS-CoV-2 VOCs in the SARS-CoV-2 pandemic.

The outbreak of COVID-19 associated rhino-orbital-cerebral mucormycosis (CA-ROCM) through the latest waves of the pandemic in several countries gathered attention to this rare fungal infection. This prospective observational study aims to evaluate the demographic and medical profile, clinical signs and symptoms (with a special focus on ophthalmic findings), imaging features, and the outcome of CA-ROCM patients. The collaborative study of COVID-19 Associated Rhino-Orbital-Cerebral Mucormycosis in Iran (CA-ROCM-IR) has been conducted in 8 tertiary referral ophthalmology centers among different provinces of Iran during the fifth wave of the COVID-19 pandemic. All patients were subjected to complete history taking and comprehensive ophthalmological examination, and underwent standard accepted treatment strategy based on the disease stage. The present report is the preliminary results of this project study. Two hundred seventy-four CA-ROCM patients, including 150 males (54.7%), who had a mean age of 56.8 ± 12.44 years, were enrolled. Diabetes mellitus was the most prevalent (82.8%) medical disease among the patients. Supplemental oxygen administration and corticosteroid use due to COVID-19 were present in a large proportion of the patients (68.2%, and 73.7% respectively). The most common primary complaints were facial pain (47.4%), facial swelling (38.3%), and nasal discharge (32.5%). Ptosis (58%), periorbital swelling (46%), and nasal congestion (40.5%) were common signs and symptoms among CA-ROCM patients. A majority of the patients (80.3%) were diagnosed at stage 3 or higher of ROCM and the rate of ocular involvement in whom was 92.3%. The most affected paranasal sinus was the ethmoid sinus (75.2%), followed by the maxillary sinus (70.8%). A total of 30 patients (10.9%) had expired before discharge from hospitals. Patients with a history of cigarette smoking (OR = 7.25), ICU admission (OR = 87.36), higher stage of the ROCM (OR = 4.22), receiving endoscopic debridement and transcutaneous retrobulbar amphotericin B (TRAMB) (OR = 4.20), and bilateral ocular involvement (OR = 2.94) had upper odds for death before discharge from hospital. History of taking systemic corticosteroids during COVID-19 was significantly associated with reduced odds of mortality (OR = 0.058, P = 0.006). Also, GEE analysis showed statistically significant higher mean LogMAR visual acuity score among expired patients (3.71, 95% CI: 3.04–4.38) compared to patients who were discharged from hospitals (2.42, 95% CI: 2.16–2.68) ( P < 0.001).

Background and AimsSARS-CoV-2, as a new pandemic disease, affected the world. Short-chain fatty acids (SCFAs) such as acetic, propionic, and butyric acids are the main metabolites of human gut microbiota. The positive effects of SCFAs have been shown in infections caused by respiratory syncytial virus, adenovirus, influenza, and rhinovirus. Therefore, this study aimed to evaluate the concentration of SCFAs in patients with SARS-CoV-2 compared with the healthy group. MethodsThis research was designed based on a case and control study. Twenty healthy individuals as the control group and 20 persons admitted to the hospital with a positive test of coronavirus disease (COVID-19) real-time polymerase chain reaction were included in the study as the patient group from September 2021 to October 2021, in Tabriz, Iran. Stool specimens were collected from volunteers, and analysis of SCFAs was carried out by a high-performance liquid chromatography system. ResultsThe amount of acetic acid in the healthy group was 67.88 & PLUSMN; 23.09 & mu;mol/g, while in the group of patients with COVID-19 was 37.04 & PLUSMN; 13.29 & mu;mol/g. Therefore, the concentration of acetic acid in the patient group was significantly (p < 0.001) lower than in the healthy group. Propionic and butyric acid were present in a higher amount in the control group compared with the case group; however, this value was not statistically significant (p > 0.05). ConclusionThis study showed that the concentration of acetic acid as the metabolite caused by gut microbiota is significantly disturbed in patients with COVID-19. Therefore, therapeutic interventions based on gut microbiota metabolites in future research may be effective against COVID-19.

Brucellosis is a thousand-face disease and a common zoonotic infection in the endemic region. A 42-year-old female was admitted with sternoclavicular arthritis and breast abscess. After laboratory investigation and imaging, positive serological test results and positive blood culture for brucella revealed acute sternoclavicular arthritis and breast abscess due to brucellosis.

Purpose: The aim of the study is to evaluate the effect of metformin in complication improvement of hospitalized patients with COVID-19. Methods: This was a randomized clinical trial that involved 189 patients with confirmed COVID-19 infection. Patients in the intervention group received metformin-500 mg twice daily. Patients who received metformin before admission were excluded from the control group. Patients who were discharged before taking at least 2000 mg of metformin were excluded from the study. Primary outcomes were vital signs, need for ICU admission, need for intubation, and mortality. Results: Data showed that patients with diabetes with previous metformin in their regimen had lower percentages of ICU admission and death in comparison with patients without diabetes (11.3% vs. 26.1% (P=0.014) and 4.9% vs. 23.9% (P≤0.001), respectively). Admission time characteristics were the same for both groups except for diabetes and hyperlipidemia, which were significantly different between the two groups. Observations of naproxen consumption on endpoints, duration of hospitalization, and the levels of spO2 did not show any significant differences between the intervention and the control group. The adjusted OR for intubation in the intervention group versus the control group was 0.21 [95% CI, 0.04-0.99 (P=0.047)]. Conclusion: In this trial, metformin consumption had no effect on mortality and ICU admission rates in non-diabetic patients. However, metformin improved COVID-19 complications in diabetic patients who had been receiving metformin prior to COVID-19 infection, and it significantly lowered the intubation rates.

Background. Despite promising results of autologous bone marrow transplantation (BMT) in patients with lymphoma, infectious complications limit its positive outcomes. This study evaluated the incidence and associated factors of the occurrence of febrile neutropenia (FN) following BMT in patients with lymphoma. Material and methods. Overall, 147 lymphoma patients who were candidates for BMT were consecutively included. Clinical and laboratory results were recorded, and after BMT, the occurrence of FN was investigated through the daily evaluation of neutrophil count and body temperature. Results. FN occurred in 91 patients (61.9 %) on average after 12.77 ± 2.45 days after BMT. Lower fluid balance was associated with a higher risk of FN (lowest adjusted odds ratio [OR] at day -2 = 0.602, 95% confidence interval [CI] = 0.299 – 0.870, p value = 0.007). The higher uric acid level was associated with a higher risk of FN (highest adjusted OR at day -10 = 1.617, 95% CI = 1.328 – 1.963, p value = 0.035). LDH also had a positive relationship with FN (highest adjusted OR at day 0 = 1.501, 95% CI = 1.198 – 2.104, p value = 0.004). Conclusion. Adequate hydration of the patients is of paramount importance for preventing FN in patients who receive BMT. Furthermore, uric acid and LDH could be considered in future studies for risk stratification of FN.

Key Clinical Message The main target of this report was that brucellosis can occur in unexpected and very rare patterns. We reported this patient to acknowledge all of clinicians especially those living in the endemic areas, that these rare complications of brucellosis can also be treated by the standard treatment of this disease. Abstract Brucellosis is a thousand‐face disease and common zoonotic infection in endemic regions. A 42‐year‐old female was admitted with sternoclavicular arthritis and breast abscess. After laboratory investigation and imaging, positive serological test results and positive blood culture for Brucella revealed acute sternoclavicular arthritis and breast abscess due to brucellosis.