Night sweats associated with a strong, peculiar, moldy odor

Q: Which Infectious Disease (ID) may present with night sweats associated with a strong, peculiar, moldy odor?

Answer: Brucellosis

Although Brucellosis has many symptoms, it is hard to distinguish from other ID symptoms, such as fever, malaise, night sweats, arthralgias, weight loss, low back pain, headache, dizziness, anorexia, dyspepsia, abdominal pain, cough, and depression, and possibly hepatomegaly, splenomegaly, and/or lymphadenopathy, but the association of night sweats with a strong, peculiar, moldy (or musty) odor is characteristic of Brucellosis.

A couple of good reviews on Brucellosis can be found in the references below.

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References:

1. Qureshi KA, Parvez A, Fahmy NA, Abdel Hady BH, Kumar S, Ganguly A, Atiya A, Elhassan GO, Alfadly SO, Parkkila S, Aspatwar A. Brucellosis: epidemiology, pathogenesis, diagnosis and treatment-a comprehensive review. Ann Med. 2023;55(2):2295398. doi: 10.1080/07853890.2023.2295398. Epub 2024 Jan 2. PMID: 38165919; PMCID: PMC10769134.

2. Khairullah AR, Kurniawan SC, Puspitasari Y, Aryaloka S, Silaen OSM, Yanestria SM, Widodo A, Moses IB, Effendi MH, Afnani DA, Ramandinianto SC, Hasib A, Riwu KHP. Brucellosis: Unveiling the complexities of a pervasive zoonotic disease and its global impacts. Open Vet J. 2024 May;14(5):1081-1097. doi: 10.5455/OVJ.2024.v14.i5.1. Epub 2024 May 31. PMID: 38938422; PMCID: PMC11199761.

3. Alavi SM, Alavi L. Treatment of brucellosis: a systematic review of studies in recent twenty years. Caspian J Intern Med. 2013 Spring;4(2):636-41. PMID: 24009951; PMCID: PMC3755828.