1
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Salcedo AS, Carreras X, Kobayashi T, Salinas JL, Muñoz S, Diaz N, Alave J. Case Report: Neurobrucellosis Presenting as Malignancy. Am J Trop Med Hyg 2024; 111:312-316. [PMID: 38861982 PMCID: PMC11310615 DOI: 10.4269/ajtmh.23-0684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/01/2024] [Indexed: 06/13/2024] Open
Abstract
Neurobrucellosis, caused by Brucella species, is a zoonotic infection that may involve the central nervous system. Although uncommon, it can manifest as a solitary intracranial mass. We report a case of neurobrucellosis in a 25-year-old woman from Peru who presented with headache, weight loss, and right-side hemiparesis and paresthesia. A contrast-enhanced magnetic resonance imaging scan revealed an intracerebral mass in the left temporal lobe. Serum testing subsequently were positive. Brain biopsy demonstrated non-necrotizing granulomas without malignant cells. Neurobrucellosis should be considered in the differential diagnosis of brain space occupying lesions in endemic countries.
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Affiliation(s)
| | | | - Takaaki Kobayashi
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | | | | | - Nelson Diaz
- Universidad Peruana Union, Lima, Peru and Clinica Good Hope, Lima, Peru
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2
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Fadul A, Fadul MH, Demir G, Safieh M, Lebbe A, Falamrz F, Mohamed A, Hamad N, Akbar RA. Brucella infection presenting as infective endocarditis complicated by embolic stroke. IDCases 2024; 36:e01937. [PMID: 38601430 PMCID: PMC11004057 DOI: 10.1016/j.idcr.2024.e01937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 03/03/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024] Open
Abstract
Brucellosis (undulant fever) is a zoonotic infection caused by Brucella species. It typically presents with fever, malaise, night sweats, and arthralgia. One of its rare complications is infective endocarditis, which occurs in approximately 1.3% of patients and can be further complicated by embolic stroke. This report describes a rare occurrence of Brucella endocarditis presenting as an embolic stroke. A 34-year-old male presented with sudden left-sided weakness and fever. He reported headaches, fever, and generalized weakness in the preceding week. The patient worked on a farm and hence had animal contact. A neurological exam showed left-sided facial weakness, and power of 0/5 and 1/5 in the left upper and lower extremities, respectively. CT scan of the head revealed a right middle cerebral artery (MCA) territory infarct with penumbra and a right MCA occlusion. He underwent a cerebral artery thrombectomy with successful recanalization. However, he continued to have fever and high inflammatory markers. Echocardiography showed aortic valve vegetation and blood cultures grew Brucella melitensis. A multidisciplinary meeting was held to determine the optimal management, which included a course of rifampicin and doxycycline.
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Affiliation(s)
- Abdalla Fadul
- Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Gokhan Demir
- Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Safieh
- Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Nabiel Hamad
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Raza A. Akbar
- Internal Medicine, Hamad Medical Corporation, Doha, Qatar
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3
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Spernovasilis N, Karantanas A, Markaki I, Konsoula A, Ntontis Z, Koutserimpas C, Alpantaki K. Brucella Spondylitis: Current Knowledge and Recent Advances. J Clin Med 2024; 13:595. [PMID: 38276100 PMCID: PMC10816169 DOI: 10.3390/jcm13020595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
The most prevalent zoonotic disease is brucellosis, which poses a significant threat for worldwide public health. Particularly in endemic areas, spinal involvement is a major source of morbidity and mortality and can complicate the course of the disease. The diagnosis of Brucella spondylitis is challenging and should be suspected in the appropriate epidemiological and clinical context, in correlation with microbiological and radiological findings. Treatment depends largely on the affected parts of the body. Available treatment options include antibiotic administration for an adequate period of time and, when appropriate, surgical intervention. In this article, we examined the most recent data on the pathophysiology, clinical manifestation, diagnosis, and management of spinal brucellosis in adults.
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Affiliation(s)
| | - Apostolos Karantanas
- Department of Medical Imaging, University Hospital of Heraklion, 71500 Heraklion, Greece;
- Advanced Hybrid Imaging Systems, Institute of Computer Science, FORTH, 71500 Heraklion, Greece
- Department of Radiology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Ioulia Markaki
- Internal Medicine Department, Thoracic Diseases General Hospital Sotiria, 11527 Athens, Greece;
| | - Afroditi Konsoula
- Department of Pediatrics, General Hospital of Sitia, 72300 Sitia, Greece;
| | - Zisis Ntontis
- Department of Orthopaedics and Trauma Surgery, Venizeleio General Hospital of Heraklion, 71409 Heraklion, Greece;
| | - Christos Koutserimpas
- Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece;
| | - Kalliopi Alpantaki
- Department of Orthopaedics and Trauma Surgery, Venizeleio General Hospital of Heraklion, 71409 Heraklion, Greece;
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4
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Mandili SY, Albishi AA, Badr OI. Case report of pulmonary brucellosis complicated by pleural effusion. Respir Med Case Rep 2023; 46:101924. [PMID: 38053628 PMCID: PMC10694564 DOI: 10.1016/j.rmcr.2023.101924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/21/2023] [Accepted: 10/03/2023] [Indexed: 12/07/2023] Open
Abstract
Brucellosis is a bacterial disease and one of the most widespread zoonoses transmitted by an animal. It can affect any organ system, but pulmonary involvement is an unusual presentation according to the literature. We report the case of a 32 -year-old lady from Saudi Arabia who suffered from persistent fever and was found to have lobar pneumonia complicated by parapneumonic effusion. She started empirical antibiotics, and many investigations were done. In the end, after more detail about the patient's circumstances, the presumptive diagnosis of Brucella was made by high serology titer. She was effectively treated with doxycycline and rifampicin and completely recovered. In conclusion, pulmonary brucellosis is infrequent and challengeable in diagnosis but should be knowledge, especially in endemic areas of brucellosis.
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Affiliation(s)
- Shuaa Y. Mandili
- Pulmonary Department, Alnoor Specialist Hospital/Ministry of Health, Mecca, Saudi Arabia
| | - Anas A. Albishi
- Internal Medicine Department, Alnoor Specialist Hospital/Ministry of Health, Mecca, Saudi Arabia
| | - Omaima ibrahim Badr
- Pulmonary Department, Alnoor Specialist Hospital/Ministry of Health, Mecca, Saudi Arabia
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5
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Xu M, Mo S, Fu X. Brucella infection-induced hemophagocytic syndrome with subsequent development of the probable vanishing bile duct syndrome: A case report and literature review. SAGE Open Med Case Rep 2023; 11:2050313X231207562. [PMID: 37901593 PMCID: PMC10612464 DOI: 10.1177/2050313x231207562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Vanishing bile duct syndrome is a rare clinical manifestation, and many clinicians tend to classify vanishing bile duct syndrome as a surgical disease and perform emergency surgery, leading to poor prognosis for patients. In this report, we present a case of a patient initially diagnosed with probable vanishing bile duct syndrome. However, through a meticulous step-by-step investigation, we ultimately determined that the patient was suffering from Brucella infection-induced hemophagocytic syndrome, which contributed to the development of the probable vanishing bile duct syndrome. Once a definitive diagnosis was established, the patient underwent treatment following anti-Brucella and Hemophagocytic lymphohistiocytosis-2004 protocols, leading to an improvement in the patient's condition. We conducted a literature review on brucellosis, and it demonstrated the lack of specificity in diagnosing Brucella infections and the diverse range of clinical manifestations. Failure to arrive at a definitive diagnosis may result in clinical misdiagnosis and delayed treatment, thereby leading to grave consequences.
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Affiliation(s)
- Musen Xu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Shaojian Mo
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Xifeng Fu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
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6
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Shaw B, Madden M, Sanchez E, Carlan S. Recurrent Neurobrucellosis in a Feral Swine Hunter. Cureus 2023; 15:e39383. [PMID: 37378215 PMCID: PMC10291976 DOI: 10.7759/cureus.39383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Brucellosis is a zoonotic infectious disease caused by the bacterial genus Brucella and is most commonly transmitted to humans globally via the consumption of contaminated unpasteurized products. In a significant minority of cases, Brucella has been found to be transmitted by contact with infected swine bodily fluids such as blood. Only a small proportion of all cases of brucellosis affects the central nervous system, and of the four species of Brucella that are known to infect humans, Brucella suis is unusual. Neurologic involvement occurs in a limited proportion of cases and can vary in presentation, ranging from encephalitis to radiculitis or from brain abscess to neuritis. In this case report, we present a 20-year-old male with an eight-day history of headache and neck pain and a high fever that started two days after the onset of the headaches. Three weeks prior, he had hunted, killed, butchered, cooked, and eaten a wild boar in the field. A workup was performed, and blood cultures eventually grew Brucella suis. Although an intensive broad-spectrum antibiotic protocol was implemented, his post-therapy course was complicated. He eventually discontinued his antibiotics after one year.
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Affiliation(s)
- Brian Shaw
- Internal Medicine, Orlando Regional Medical Center, Orlando, USA
| | - Melinda Madden
- Internal Medicine, Orlando Regional Medical Center, Orlando, USA
| | - Edgar Sanchez
- Infectious Diseases, Orlando Regional Medical Center, Orlando, USA
| | - Steve Carlan
- Academic Affairs, Orlando Regional Medical Center, Orlando, USA
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7
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Dabaja-Younis H, Atarieh M, Paul M, Nasrallah E, Geffen Y, Kassis I, Ghanem-Zoubi N. Predictive factors for focal disease in human brucellosis, an observational cohort study. Eur J Clin Microbiol Infect Dis 2023; 42:221-226. [PMID: 36547765 DOI: 10.1007/s10096-022-04541-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
This retrospective cohort study aimed to identify predictors for focal disease in human brucellosis. The study included patients with brucellosis diagnosed between January 2000 and December 2021. Overall, 247 patients were identified. Focal disease was diagnosed in 64 (25.9%) patients. The most common focal infection was bone and joint in 56 patients (23.4%). Disease duration > 14 days was significantly associated with focal illness [OR = 2.2 (1.08-4.47), p = 0.030], although febrile illness was inversely associated with focal illness this did not reach statistical significance [OR = 0.46 (0.21-1.00), p = 0.050]. Focal brucellosis should be suspected in patients with prolonged illness.
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Affiliation(s)
- Halima Dabaja-Younis
- Pediatric Infectious Diseases Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. .,The Ruth and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology, Technion, Haifa, Israel.
| | - Menas Atarieh
- The Ruth and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology, Technion, Haifa, Israel
| | - Michal Paul
- The Ruth and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology, Technion, Haifa, Israel.,Infectious Diseases Unit, Rambam Health Care Campus, Haifa, Israel
| | - Elias Nasrallah
- Pediatric Infectious Diseases Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Yuval Geffen
- Microbiology Laboratory, Rambam Health Care Campus, Haifa, Israel
| | - Imad Kassis
- Pediatric Infectious Diseases Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology, Technion, Haifa, Israel
| | - Nesrin Ghanem-Zoubi
- The Ruth and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology, Technion, Haifa, Israel.,Infectious Diseases Unit, Rambam Health Care Campus, Haifa, Israel
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8
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Zheng H, Liu D, Zhao X, Zhao X, Liu Y, Li D, Shi T, Ren X. Influence and prediction of meteorological factors on brucellosis in a northwest region of China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:9962-9973. [PMID: 36064850 DOI: 10.1007/s11356-022-22831-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
This paper aims to study the cumulative lag effect of meteorological factors on brucellosis incidence and the prediction performance based on Random Forest model. The monthly number of brucellosis cases and meteorological data from 2015 to 2019 in Yongchang of Gansu Province, northwest China, were used to build distributed lag nonlinear model (DLNM). The number of brucellosis cases of lag 1 month and meteorological data from 2015 to 2018 were used to build RF model to predict the brucellosis incidence in 2019. Meanwhile, SARIMA model was established to compare the prediction performance with RF model according to R2 and RMSE. The results indicated that the population had a high incidence risk at temperature between 5 and 13 °C and lag between 0 and 18 days, sunshine duration between 225 and 260 h and lag between 0 and 1 month, and atmosphere pressure between 789 and 793.5 hPa and lag between 0 and 18 days. The R2 and RMSE of train set and test set in RF model were 0.903, 1.609, 0.824, and 2.657, respectively, and the R2 and RMSE in SARIMA model were 0.530 and 7.008. This study found significant nonlinear and lag associations between meteorological factors and brucellosis incidence. The prediction performance of RF model was more accurate and practical compared with SARIMA model.
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Affiliation(s)
- Hongmiao Zheng
- School of Public Health, Lanzhou University, Gansu, China
| | - Dongpeng Liu
- Gansu Provincial Center for Disease Control and Prevention, Gansu, China
| | - Xin Zhao
- School of Public Health, Lanzhou University, Gansu, China
| | - Xiangkai Zhao
- School of Public Health, Lanzhou University, Gansu, China
| | - Yanchen Liu
- School of Public Health, Lanzhou University, Gansu, China
| | - Donghua Li
- School of Public Health, Lanzhou University, Gansu, China
| | - Tianshan Shi
- School of Public Health, Lanzhou University, Gansu, China
| | - Xiaowei Ren
- School of Public Health, Lanzhou University, Gansu, China.
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9
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Di Bari C, Venkateswaran N, Bruce M, Fastl C, Huntington B, Patterson GT, Rushton J, Torgerson P, Pigott DM, Devleesschauwer B. Methodological choices in brucellosis burden of disease assessments: A systematic review. PLoS Negl Trop Dis 2022; 16:e0010468. [PMID: 36512611 PMCID: PMC9794075 DOI: 10.1371/journal.pntd.0010468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 12/27/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Foodborne and zoonotic diseases such as brucellosis present many challenges to public health and economic welfare. Increasingly, researchers and public health institutes use disability-adjusted life years (DALYs) to generate a comprehensive comparison of the population health impact of these conditions. DALYs calculations, however, entail a number of methodological choices and assumptions, with data gaps and uncertainties to accommodate. Thisreview identifies existing brucellosis burden of disease studies and analyzes their methodological choices, assumptions, and uncertainties. It supports the Global Burden of Animal Diseases programme in the development of a systematic methodology to describe the impact of animal diseases on society, including human health. METHODS/PRINCIPAL FINDINGS A systematic search for brucellosis burden of disease calculations was conducted in pre-selected international and grey literature databases. Using a standardized reporting framework, we evaluated each estimate on a variety of key methodological assumptions necessary to compute a DALY. Fourteen studies satisfied the inclusion criteria (human brucellosis and quantification of DALYs). One study reported estimates at the global level, the rest were national or subnational assessments. Data regarding different methodological choices were extracted, including detailed assessments of the adopted disease models. Most studies retrieved brucellosis epidemiological data from administrative registries. Incidence data were often estimated on the basis of laboratory-confirmed tests. Not all studies included mortality estimates (Years of Life Lost) in their assessments due to lack of data or the assumption that brucellosis is not a fatal disease. Only two studies used a model with variable health states and corresponding disability weights. The rest used a simplified singular health state approach. Wide variation was seen in the duration chosen for brucellosis, ranging from 2 weeks to 4.5 years, irrespective of the whether a chronic state was included. CONCLUSION Available brucellosis burden of disease assessments vary widely in their methodology and assumptions. Further research is needed to better characterize the clinical course of brucellosis and to estimate case-fatality rates. Additionally, reporting of methodological choices should be improved to enhance transparency and comparability of estimates. These steps will increase the value of these estimates for policy makers.
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Affiliation(s)
- Carlotta Di Bari
- GBADs programme -, Liverpool, United Kingdom
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- * E-mail:
| | - Narmada Venkateswaran
- GBADs programme -, Liverpool, United Kingdom
- Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Mieghan Bruce
- GBADs programme -, Liverpool, United Kingdom
- Centre for Biosecurity and One Health, School of Veterinary Medicine, Harry Butler Institute, Murdoch University, Perth, Western Australia
| | - Christina Fastl
- GBADs programme -, Liverpool, United Kingdom
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Ben Huntington
- GBADs programme -, Liverpool, United Kingdom
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- Pengwern Animal Health Ltd, Wallasey Wirral, Merseyside, United Kingdom
| | - Grace T. Patterson
- GBADs programme -, Liverpool, United Kingdom
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Jonathan Rushton
- GBADs programme -, Liverpool, United Kingdom
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Paul Torgerson
- GBADs programme -, Liverpool, United Kingdom
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - David M. Pigott
- GBADs programme -, Liverpool, United Kingdom
- Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Brecht Devleesschauwer
- GBADs programme -, Liverpool, United Kingdom
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
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10
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Ta N, Mi J, Li X, Guo W, Yu G, Li G, Pang S, Bai W, Liu Q, Zhao H, Wei G, Fan M, Wen Y. Epidemiological Characteristics and Clinical Manifestations of Brucellosis and Q Fever Among Humans from Northeastern Inner Mongolia. Infect Drug Resist 2022; 15:6501-6513. [PMID: 36386408 PMCID: PMC9645112 DOI: 10.2147/idr.s381370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Objective To investigate the distribution, epidemiology, and clinical symptoms of brucellosis and Q fever in northeastern Inner Mongolia. Methods In this study, 64 townships of Bairin left flag and Alukerqin flag, Jarud flag and Horqin right front flag in four counties with frequent brucellosis and Q fever were selected. Epidemiological characteristics, clinical features, and exposure to risk factors were identified and descriptively analyzed in patients from these areas. Results There were 367 brucellosis cases in the four regions and 78 positive cases of Q-fever infection. In addition, 24 cases of brucellosis and Q-fever co-infection were identified, with a co-infection rate of 1.13%. Brucellosis and Q fever were mainly concentrated in the 30–65 and 40–55 age groups. For brucellosis, the difference between age groups was statistically significant (χ2 = 29.121, P < 0.05). The sex distribution for brucellosis was 225 men (61.31%) and 142 women (38.69%), and 45 men (57.69%) and 33 women (42.31%) had Q fever. Those with brucellosis and Q fever were mainly farmers, accounting for 79.19% and 78.38% of the total number, respectively. Of the 367 cases of brucellosis infection, the main symptoms were joint pain (52.59%), fatigue (47.14%), lower back pain (38.96%), fever (33.24%), hyperhidrosis (28.88%), and muscle pain (20.44%). Of the 78 cases of Q-fever infection, the main symptoms were joint pain (35.90%), fatigue (30.77%), lower back pain (26.92%), fever (21.79%), and hyperhidrosis (17.95%). Muscle pain also accounted for 12.82%. Conclusion Occupational distribution suggests that we should strengthen the protection measures against diseases infected through animal husbandry. Among the clinical symptoms, fever, hyperhidrosis and fatigue were associated with brucellosis, while fever, headache, and fatigue were significantly associated with Q fever.
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Affiliation(s)
- Na Ta
- School of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, People’s Republic of China
- Inner Mongolia Center for Disease Control and Research, Hohhot, People’s Republic of China
| | - Jingchuan Mi
- Inner Mongolia Center for Disease Control and Research, Hohhot, People’s Republic of China
| | - Xiaoyan Li
- Inner Mongolia Center for Disease Control and Research, Hohhot, People’s Republic of China
| | - Wei Guo
- Inner Mongolia Center for Disease Control and Research, Hohhot, People’s Republic of China
| | - Gaowa Yu
- Tong Liao Center for Endemic Disease Control and Research, Tong Liao, People’s Republic of China
| | - Guojun Li
- Chi Feng Center for Disease Control and Research, Chi Feng, People’s Republic of China
| | - Shuchun Pang
- Xingan Meng Center for Disease Control and Research, Xingan Meng, People’s Republic of China
| | - Wuyun Bai
- Keyouqian QI Center for Disease Control and Research, Xingan Meng, People’s Republic of China
| | - Qingjie Liu
- Zhalute Qi Center for Disease Control and Research, Chi Feng, People’s Republic of China
| | - Haijun Zhao
- Alukerqin Qi Center for Disease Control and Research, Chifeng, People’s Republic of China
| | - Guangjun Wei
- Balinzuo Qi Center for Disease Control and Research, Chi Feng, People’s Republic of China
| | - Mengguang Fan
- Inner Mongolia Center for Disease Control and Research, Hohhot, People’s Republic of China
| | - Yongjun Wen
- School of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, People’s Republic of China
- Correspondence: Yongjun Wen, School of Veterinary Medicine, Inner Mongolia Agricultural University, No. 306, Zhaowuda Road, Saihan District, Hohhot, 010018, Inner Mongolia, People’s Republic of China, Email
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11
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Muacevic A, Adler JR. Immune Thrombocytopenic Purpura and Its Rare Association With a Brucella Infection: A Case Report. Cureus 2022; 14:e30049. [PMID: 36381884 PMCID: PMC9637444 DOI: 10.7759/cureus.30049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 01/25/2023] Open
Abstract
Although several factors such as viral and bacterial pathogens, and drugs have been widely reported to be associated with immune thrombocytopenic purpura (ITP), brucellosis is an unusual cause of this disorder. Here, we describe a patient with brucellosis with fever and purpura as the first manifestation of her illness due to immune-mediated severe thrombocytopenia. In this case, ITP responded well to the anti-Brucella treatment with platelet recovery within three days.
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12
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Brucellosis: A Rare Cause of Febrile Neutropenia in a Child. Pediatr Infect Dis J 2022; 41:e430-e433. [PMID: 35830519 DOI: 10.1097/inf.0000000000003630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report a case of brucellosis-induced severe neutropenia in a 2-year-old girl who presented with a 2-week history of fever. On clinical examination, the patient was febrile with mild aphthous stomatitis. However, her general condition was stable, and systemic examination did not show involvement of any other organ. Laboratory test results revealed severe neutropenia, mild anemia, and an elevated serum C-reactive protein level. Flow cytometry of peripheral blood leukocytes revealed no malignancy, and blood film morphology was unremarkable except for mild microcytosis and hypochromia. Antineutrophil antibody and Coombs test results were negative. We administered intravenous cefuroxime; however, therapy was switched to meropenem plus clarithromycin because fever persisted for 5 days, despite treatment. On the 10th day after admission, Brucella serology tests showed positive results, and trimethoprim-sulfamethoxazole plus rifampicin therapy was prescribed for 8 weeks. The fever defervesced, and the child was discharged in a good state of health. Neutropenia persisted for several months but gradually resolved. Neutropenia, defined as an absolute neutrophil count (ANC) < 1.5 cells × 10 9 /L beyond the first year of life, is a benign transient condition associated with an intercurrent infection (usually viral illnesses or infections) in immunocompetent children. However, severe neutropenia (ANC < 0.5 × 10 9 /L) associated with fever necessitates hospitalization and administration of broad-spectrum antibiotics to avoid the high risk of sepsis, particularly in children. Brucellosis is rarely associated with hematologic abnormalities such as neutropenia. Early diagnosis of hematologic complications of brucellosis is essential for prompt initiation of specific and aggressive treatment.
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13
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Copur B, Sayili U. Laboratory and clinical predictors of focal involvement and bacteremia in brucellosis. Eur J Clin Microbiol Infect Dis 2022; 41:793-801. [PMID: 35364783 DOI: 10.1007/s10096-022-04436-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
Abstract
Early diagnosis of organ involvement and bacteremia in brucellosis increases treatment success and may prevent poor clinical outcomes. This study aimed to investigate the predictors of focal involvement and bacteremia in patients with brucellosis. A total of 139 brucellosis patients aged 16 years and older were included in the study. Patients with and without organ involvement and bacteremic and non-bacteremic patients were compared separately. Low back pain, lymphadenomegaly, absence of fever on admission, ESR, AST, and neutrophil-lymphocyte ratio (NLR) were predictors of focal involvement (OR: 2.604; 3.167; 7.224; 1.039; 1.032; 1.738, respectively). The AUC value of ESR was 0.669 (0.573-0.765, p = 0.002) with the cutoff point > 30 mm/h (sensitivity 89.74% and specificity 37.00%) in predicting focal involvement in patients with brucellosis. Myalgia and headache (OR: 2.970; 2692) were defined as clinical predictors of Brucella bacteremia. Focal involvement should be considered in patients with brucellosis in the absence of myalgia and fever, presence of low back pain, and sedimentation > 30 mm/h. Brucella bacteremia should be considered regardless of fever, especially in patients with myalgia and headache in endemic areas.
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Affiliation(s)
- Betul Copur
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Sultangazi, Istanbul, Turkey.
| | - Ugurcan Sayili
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Department of Biostatistics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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14
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Moreno E, Blasco JM, Moriyón I. Facing the Human and Animal Brucellosis Conundrums: The Forgotten Lessons. Microorganisms 2022; 10:942. [PMID: 35630386 PMCID: PMC9144488 DOI: 10.3390/microorganisms10050942] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/22/2022] [Accepted: 04/28/2022] [Indexed: 11/17/2022] Open
Abstract
Brucellosis is a major zoonotic disease caused by Brucella species. Historically, the disease received over fifty names until it was recognized as a single entity, illustrating its protean manifestations and intricacies, traits that generated conundrums that have remained or re-emerged since they were first described. Here, we examine confusions concerning the clinical picture, serological diagnosis, and incidence of human brucellosis. We also discuss knowledge gaps and prevalent confusions about animal brucellosis, including brucellosis control strategies, the so-called confirmatory tests, and assumptions about the primary-binding assays and DNA detection methods. We describe how doubtfully characterized vaccines have failed to control brucellosis and emphasize how the requisites of controlled safety and protection experiments are generally overlooked. Finally, we briefly discuss the experience demonstrating that S19 remains the best cattle vaccine, while RB51 fails to validate its claimed properties (protection, differentiating infected and vaccinated animals (DIVA), and safety), offering a strong argument against its current widespread use. These conundrums show that knowledge dealing with brucellosis is lost, and previous experience is overlooked or misinterpreted, as illustrated in a significant number of misguided meta-analyses. In a global context of intensifying livestock breeding, such recurrent oversights threaten to increase the impact of brucellosis.
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Affiliation(s)
- Edgardo Moreno
- Tropical Disease Research Program, National University, Heredia 40104, Costa Rica;
| | | | - Ignacio Moriyón
- Institute for Tropical Health and Department of Microbiology and Parasitology, Medical School, University of Navarra and IdISNA, 31008 Pamplona, Spain
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15
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Akermi SE, L'Hadj M, Selmane S. Epidemiology and time series analysis of human brucellosis in Tebessa province, Algeria, from 2000 to 2020. J Res Health Sci 2022; 22:e00544. [PMID: 36511254 PMCID: PMC9315461 DOI: 10.34172/jrhs.2022.79] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/28/2022] [Accepted: 02/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Brucellosis runs rampant endemically with sporadic outbreaks in Algeria. The present study aimed to provide insights into the epidemiology of brucellosis and compare the performance of some prediction models using surveillance data from Tebessa province, Algeria. STUDY DESIGN A retrospective study. METHODS Seasonal autoregressive integrated moving average (SARIMA), neural network autoregressive (NNAR), and hybrid SARIMA-NNAR models were developed to predict monthly brucellosis notifications. The prediction performance of these models was compared using root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE). RESULTS Overall, 13 670 human brucellosis cases were notified in Tebessa province from 2000-2020 with a male-to-female ratio of 1.3. The most affected age group was 15-44 years (56.2%). The cases were reported throughout the year with manifest seasonality. The annual notification rate ranged from 30.9 (2013) to 246.7 (2005) per 100 000 inhabitants. The disease was not evenly distributed, rather spatial and temporal variability was observed. The SARIMA (2,1,3) (1,1,1)12, NNAR (12,1,6)12, and SARIMA (2,0,2) (1,1,0)12-NNAR (5,1,4)12 were selected as the best-fitting models. The RMSE, MAE, and MAPE of the SARIMA and SARIMA-NNAR models were by far lower than those of the NNAR model. Moreover, the SARIMA-NNNAR hybrid model achieved a slightly better prediction accuracy for 2020 than the SARIMA model. CONCLUSION As evidenced by the obtained results, both SARIMA and hybrid SARIMA-NNAR models are suitable to predict human brucellosis cases with high accuracy. Reasonable predictions, along with mapping brucellosis incidence, could be of great help to veterinary and health policymakers in the development of informed, effective, and targeted policies, as well as timely interventions.
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Affiliation(s)
- Seif Eddine Akermi
- L'IFORCE, Faculty of Mathematics, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
| | - Mohamed L'Hadj
- Beni Messous University Hospital Centre, Ministry of Health, Population and Hospital Reform, Algiers, Algeria
| | - Schehrazad Selmane
- L'IFORCE, Faculty of Mathematics, University of Sciences and Technology Houari Boumediene, Algiers, Algeria.
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16
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Gowe I, Parsons C, Vickery S, Best M, Prechter S, Haskell MG, Parsons E. Venous thrombosis, peripheral aneurysm formation, and fever in a feral pig hunter with Brucellosis. IDCases 2022; 27:e01449. [PMID: 35198390 PMCID: PMC8844863 DOI: 10.1016/j.idcr.2022.e01449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 01/18/2023] Open
Abstract
Brucellosis is a systemic bacterial zoonotic disease with potential endovascular complications including endocarditis, although multifocal vasculopathy is rare. Moreover, swine-associated human infections are less common since brucellosis was eradicated in commercial swine in U.S. states and territories. However, feral swine continue to serve as a reservoir for Brucella suis. We describe the case of a feral swine hunter who presented with fever and respiratory symptoms and was diagnosed with pulmonary embolus. Blood cultures revealed growth of Brucella, later confirmed as Brucella suis. Despite initial appropriate antimicrobial therapy, he maintained fever with worsening knee pain, and magnetic resonance imaging and two-dimensional echocardiography subsequently confirmed the presence of a thrombosed popliteal artery aneurysm and mitral valve vegetation, respectively. To our knowledge, this is the first report of contemporaneous venous and arterial thromboembolism attributable to B. suis infection.
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Affiliation(s)
- Ivan Gowe
- Infection Prevention and Control Department, Margaret R Pardee Hospital, 800 North Justice Street, Hendersonville, NC 28791, USA
| | - Christopher Parsons
- Pardee Hospital Center for Infectious Diseases, 705 6th Avenue West, Suite D, Hendersonville, NC 28739, USA
| | - Stephen Vickery
- Wingate University School of Pharmacy, 805 6th Avenue West, Suite 200, Hendersonville, NC 28739, USA
| | - Michael Best
- Department of Microbiology, Margaret R. Pardee Memorial Hospital, 800 North Justice Street, Hendersonville, NC 28791, USA
| | - Scott Prechter
- Department of Radiology, Margaret R. Pardee Memorial Hospital, 800 North Justice Street, Hendersonville, NC 28791, USA
| | | | - Eveline Parsons
- Department of Animal Science, Berry College, P.O. Box 493259, Mount Berry, GA 30149, USA
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17
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Youssef N, Youssef Y, Noun D, Abboud M, Dbaibo G. Brucellosis causing bone marrow aplasia in an 11-year-old patient with complete recovery after treatment. IDCases 2022; 29:e01531. [PMID: 35761797 PMCID: PMC9233216 DOI: 10.1016/j.idcr.2022.e01531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/27/2022] Open
Abstract
Brucellosis is one of the most prevalent zoonotic infections in the Middle East. The disease may present with a range of symptoms from a simple febrile illness to severe invasive infections affecting different organ systems (meningitis, osteomyelitis). In this paper we present an eleven-year-old girl who was diagnosed with “idiopathic bone marrow aplasia” and planned for hematopoietic stem cell transplant (HSCT), when pre-transplant work-up showed high brucella titers. The patient was started on doxycycline, rifampin and gentamicin initially, with discontinuation of the latter 3 weeks into therapy. She recovered completely after 8 months of treatment.
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18
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Neurobrucellosis: Brief Review. Neurologist 2021; 26:248-252. [PMID: 34734902 DOI: 10.1097/nrl.0000000000000348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Brucella are small, nonmotile, intracellular, and aerobic gram-negative bacteria. Of the 10 species that currently form the genus Brucella, 5 were shown to be pathogenic in humans. REVIEW SUMMARY The epidemiology, clinical manifestations, diagnosis and imaging, and treatment of neurobrucellosis will be reviewed.Brucellosis's transmission to humans occurs by direct contact with contaminated animals. Older patients are at increased risk of nervous system involvement in brucellosis. Brucella spp. can lead to central nervous system involvement through direct damage via invasion of neural tissue or indirect damage caused by endotoxins or immune inflammatory reactions elicited by the presence of the bacteria in the body. Patients can have general nonspecific symptoms in addition to neurological and psychiatric symptoms. There are 4 diagnostic criteria for the diagnosis of neurobrucellosis, which include signs and symptoms suggestive of neurobrucellosis, a positive finding of Brucella spp. in the cerebrospinal fluid (CSF), and/or a positive titer of antibodies targeting brucella in the CSF, lymphocytosis with high protein levels and low glucose levels in CSF, and imaging findings (either cranial magnetic resonance imaging or computed tomography) peculiar to neurobrucellosis. For the treatment, a combined therapy is favored over monotherapy for the eradication of Brucella. Moreover, a multirouted therapy has been associated with increased treatment efficacy. The prognosis of neurobrucellosis is dependent on patients' clinical presentation: brucellar meningitis is associated with a good prognosis, whereas diffuse central nervous system involvement is associated with the development of long-term sequelae. CONCLUSIONS Neurobrucellosis affects patients globally and in endemic areas. Neurologists should familiarize themselves with its clinical presentation, diagnosis, and treatment to provide optimal care for their patients.
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19
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Arockiaraj J, Arockiaraj M, Attia WI, Almusrea KN. Brucellosis of the Spine in Children-An Analysis of 5 Children From an Endemic Setting. Int J Spine Surg 2021; 15:840-847. [PMID: 34266937 DOI: 10.14444/8108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Brucellosis of the spine is quite common among adults in endemic regions. The incidence of brucellosis of the spine affecting children is very rare. This article describes the clinical characteristics, diagnosis, management and outcome of children with brucellosis of the spine. It also aims to create awareness among all health care professionals, especially spine surgeons, regarding this rare entity. METHODS This was a retrospective study of children aged less than 15 years who were diagnosed and treated for brucellosis of the spine. Confirmed cases of brucellosis in children who had completed a full course of a triple-drug regimen as per Centers for Disease Control and Prevention (CDC) guidelines were included. Outcome analysis included both clinical and radiological measures. Clinical measures included pain, neurological status, and return to school. Resolution of the abscess and sclerosis of the involved vertebra were taken as the radiological measure. RESULTS A total of 5 children (4 boys and 1 girl) with an average age of 10 years, ranging from 6 to 14 years, fulfilled the inclusion criteria. The mean follow-up period was 32 months. All children presented with fever, back pain, and constitutional symptoms. Two of them had neurological deficits, and posttreatment, they improved to near normal neurological status. Only 1 child with an epidural abscess compressing the lumbar canal required surgical intervention. All the children were treated with a triple-drug regimen. Longer duration of treatment (14 months) was given for 2 children with history of relapse. All children were healed of the disease without any sequalae or relapse. CONCLUSIONS Blood culture and standard agglutination tests are mandatory for the diagnosis of brucellosis. Children tolerated the triple-drug regimen well. Prolonged duration of treatment was required for children with relapse. Health education to all treating health care professionals and parents is of paramount importance for treatment and control of this endemic disease.
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Affiliation(s)
- Justin Arockiaraj
- Spine Surgery Department, National Neurosciences Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Magdalenal Arockiaraj
- Paediatric Emergency Department, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Walid Ismail Attia
- Spine Surgery Department, National Neurosciences Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Khaled N Almusrea
- Spine Surgery Department, National Neurosciences Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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20
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Varikkodan I, Naushad VA, Purayil NK, Mathew J, Alrawi FM. Complicated Brucellosis With Multisystem Involvement: Two Case Reports. Cureus 2021; 13:e15950. [PMID: 34336447 PMCID: PMC8312997 DOI: 10.7759/cureus.15950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2021] [Indexed: 12/04/2022] Open
Abstract
Brucellosis is a zoonotic infection caused by facultative intracellular bacteria of the genus Brucella. The ability of the organism to invade both phagocytic and non-phagocytic cells and survive in the intracellular environment makes brucellosis a systemic infection that can affect various organs of the body. Complications of brucellosis occur when the infection involves one or more focal body sites. Early identification of complications of brucellosis and initiation of appropriate treatment is the key to a better outcome. Here we present two cases of complicated brucellosis, both having multiple body site involvement.
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Affiliation(s)
| | - Vamanjore A Naushad
- College of Medicine, Qatar University, Doha, QAT.,Internal Medicine, Weill Cornell, Doha, QAT.,General Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | - Nishan K Purayil
- Internal Medicine, Weill Cornell, Doha, QAT.,General Internal Medicine, Hamad Medical Corporation, Doha, QAT.,College of Medicine, Qatar University, Doha, QAT
| | - Joe Mathew
- General Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Clinical Medicine, College of Medicine, Qatar University, Doha, QAT.,Clinical Medicine, Weill Cornell, Doha, QAT
| | - Farooq M Alrawi
- General Internal Medicine, Hamad Medical Corporation, Doha, QAT
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21
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Zhou Y, Xie S, Zheng R, Dai Q, Xu Z, Zuo W, Ding J, Zhang Y. Brucellar reproductive system injury: A retrospective study of 22 cases and review of the literature. J Int Med Res 2021; 48:300060520924548. [PMID: 32552113 PMCID: PMC7303501 DOI: 10.1177/0300060520924548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective We aimed to describe the clinical characteristics and prognosis of 22
patients with Brucella-induced reproductive system
injury. Methods We assessed 22 patients with reproductive system injury between 2010 and 2018
at The First Affiliated Hospital of Xinjiang Medical University. Results The disease is predominant in men. Male patients had orchitis, erectile
dysfunction, prostatitis, and urethral stricture, while female patients had
vaginitis and cervicitis. Some patients had laboratory abnormalities and
liver injury. Patients received combination therapy of rifampicin and
doxycycline. Doxycycline combined with levofloxacin or moxifloxacin was
administered to patients with rifampicin intolerance. All patients had
received antibiotic therapy for at least 6 weeks. One patient was lost to
follow-up, one patient relapsed because of osteoarthropathy, and one patient
had dysuria resulting from chronic prostatitis. The clinical symptoms
resolved in the other patients, and the overall patient prognosis was
good. Conclusion Clinicians should pay attention to brucellosis-induced reproductive system
damage. The two-drug regimen of rifampicin+doxycycline is recommended for
these patients. Doxycycline combined with levofloxacin or moxifloxacin
should be used in patients with brucellosis-induced reproductive system
damage who have rifampicin intolerance. The treatment course should be at
least 6 weeks.
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Affiliation(s)
- Yan Zhou
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Songsong Xie
- The First Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Rongjiong Zheng
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qinqi Dai
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zheng Xu
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Weize Zuo
- The First Hospital of Shihezi University, Shihezi, Xinjiang, China
| | - Jianbing Ding
- Department of Immunology, Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Yuexin Zhang
- Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.,Department of Immunology, Basic Medical College, Xinjiang Medical University, Urumqi, China
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22
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Khezzani B, Narimane Aouachria A, Khechekhouche EA, Djaballah S, Djedidi T, Bosilkovski M. [Not Available]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2021; 33:275-284. [PMID: 34553872 DOI: 10.3917/spub.212.0275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Brucellosis, the most common zoonosis globally, is considered a major public health problem. OBJECTIVE A retrospective study was carried out over 21 years (1998-2018) to determine the epidemiological features of human brucellosis in the province of El-Oued (south-eastern Algeria). RESULTS 1,832 confirmed cases of human brucellosis were reported during the study period, with an average incidence rate of around 12.26 cases per 100,000 inhabitants. The annual distribution of the incidence was characterized by an increasing trend and a strong fluctuation ; its values ranged between 2.27 and 24.96 per 100,000 inhabitants. The monthly distribution showed that the highest incidence rates were recorded from mid-February to July, with a peak of 2.74 cases per 100,000 inhabitants in April.Human brucellosis has affected all municipalities. The highest incidence rate was observed in border municipalities such as Ben Guecha and Oum Tiour (89.76 and 66.14 per inhabitants, respectively).The incidence in the male population was higher than that of the female at 14.63 versus 9.83 per 100,000 inhabitants, respectively, noting that it increases with age. Individuals over 65 years are the most at risk, with an incidence rate of 22.32 per 100,000 inhabitants. CONCLUSION Along with strengthening preventive measures in the population, eliminating brucellosis in animals is the most effective method to protect humans against infection.
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23
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Bosilkovski M, Keramat F, Arapović J. The current therapeutical strategies in human brucellosis. Infection 2021; 49:823-832. [PMID: 33650077 DOI: 10.1007/s15010-021-01586-w] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/08/2021] [Indexed: 12/17/2022]
Abstract
Prompt and adequate treatment of human brucellosis continues to be the most important strategy in its management, as eradication of animal brucellosis is not possible so far, and there is no adequate vaccine for humans. The goal of antibrucellar treatment is to alleviate and shorten the symptomatic period and reduce complications, relapses, and chronicity. Contemporary trends in the treatment of human brucellosis are postulated on the ability of Brucellae to persist in host macrophages through the inhibition of phagolysosome fusion and to survive for prolonged periods intracellularly without restricting basic cellular functions. As a result of this and despite satisfactory antibiotic treatment, relapses and therapeutical failures are inevitable to a certain degree. The current principles for the treatment of brucellosis advocate for a long enough treatment duration combined with antimicrobial regimens that possess activity in the intracellular acidic environment. In the future, other antimicrobial agents, immunomodulation, decrease in the intracellular acidic environment, or development of agents that would act on well-defined molecular bacterial targets, might be incorporated to improve the therapeutical effects.
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Affiliation(s)
- Mile Bosilkovski
- Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, University Clinic for Infectious Diseases, Skopje, Republic of North Macedonia.
- Working Group On Zoonoses, International Society for Chemotherapy, Aberdeen, UK.
- Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Fariba Keramat
- Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jurica Arapović
- Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.
- Faculty of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.
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24
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Gemcioglu E, Erden A, Karabuga B, Davutoglu M, Ates I, Kücüksahin O, Güner R. False positivity of Rose Bengal test in patients with COVID-19: case series, uncontrolled longitudinal study. SAO PAULO MED J 2020; 138:561-562. [PMID: 33206914 PMCID: PMC9685578 DOI: 10.1590/1516-3180.2020.0484.03092020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/03/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Emin Gemcioglu
- MD. Physician, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Abdulsamet Erden
- MD. Physician, Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Berkan Karabuga
- MD. Resident, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Mehmet Davutoglu
- MD. Resident, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Ihsan Ates
- MD. Associate Professor, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Orhan Kücüksahin
- MD. Associate Professor, Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Rahmet Güner
- MD. Professor, Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
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25
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A Young Adult from the Middle East with Septic Shock, Pancytopenia, and Systolic Dysfunction. Ann Am Thorac Soc 2020; 16:1052-1056. [PMID: 31368803 DOI: 10.1513/annalsats.201809-624cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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26
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Perez A, Berhe M. Brucella, a bacterium with multiple ways of causing infection. Proc (Bayl Univ Med Cent) 2020; 34:99-101. [PMID: 33456160 DOI: 10.1080/08998280.2020.1805674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Brucellosis is a zoonotic infection caused by the intracellular gram-negative bacterium Brucella. It is the most common zoonosis worldwide, and its transmission is classically associated with consumption of unpasteurized animal products. However, other mechanisms of transmission include contact of the skin or mucous membranes with infected animal tissue. We present a case of a patient who had more than one possible route of infection.
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Affiliation(s)
- Alejandro Perez
- Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas
| | - Mezgebe Berhe
- Department of Infectious Diseases, North Texas Infectious Diseases Consultants, Dallas, Texas
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27
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Abstract
Objective: Brucellosis is a multisystemic disease which may affect all organs. Epididymo-orchitis is the most common form of genitourinary involvement. The aim of this study was to present our eight-year experience regarding the management of patients with brucellar epididymo-orchitis (BEO).Materials and method: The medical records of male brucellosis patients treated in two centers, between 2010 and 2018 were analyzed retrospectively. The diagnosis of epididymo-orchitis was made when the patients had scrotal pain, swelling, and enlarged tender testicles and/or epididymis on clinical examination. Brucellosis was diagnosed with a positive standard tube agglutination test or a positive blood culture.Results: Brucellosis was diagnosed in 996 male patients. Of these patients, 25 had a diagnosis of BEO (2.5%). All BEO patients suffered from enlarged painful testicles, however, testicular complaints were the only presentation symptoms in three of them. All patients received medical treatment alone except one patient with testicular abscess who underwent surgical drainage besides medical treatment. All patients recovered completely and no relapses have been detected during six-month follow-up.Conclusion: Patients with epididymo-orchitis should be investigated for brucellosis especially in endemic regions. To our knowledge, BEO patients may present with isolated testicular symptoms that make a diagnostic challenge.
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Affiliation(s)
- Hasan Tahsin Gozdas
- Department of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Tayibe Bal
- Department of Infectious Diseases and Clinical Microbiology, Siirt State Hospital, Siirt, Turkey
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28
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Brucellar Spondylitis in Kermanshah as an Endemic Area in West of Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2019. [DOI: 10.5812/archcid.93707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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29
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Acute Thyroiditis Associated with Brucellosis: A Case Report. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2019; 40:113-117. [PMID: 31605594 DOI: 10.2478/prilozi-2019-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Brucella thyroiditis represents an extremely rare focal form of brucellosis. In this case report we describe a 55 years old male, diagnosed with brucellosis and peripheral arthritis with subsequent development of acute thyroiditis. The symptoms duration consistent with brucellosis started two weeks before establishing the diagnosis. Only a day after diagnosis and initiation of antibrucellar treatment, acute non-suppurative thyroiditis suddenly manifested. Thyroiditis was diagnosed with clinical inspection and confirmed by ultrasound investigation. With the appropriate antibrucellar treatment, complete cure of thyroid affection was reached in ten days and the patient remained well during the follow-up period of two and a half years. In conclusion, in brucellosis endemic regions brucellosis should be included in the diagnostic consideration in patients with acute non-suppurative thyroiditis. Early recognition and adequate treatment of brucella thyroiditis results in favorable outcome.
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Charypkhan D, Sultanov AA, Ivanov NP, Baramova SA, Taitubayev MK, Torgerson PR. Economic and health burden of brucellosis in Kazakhstan. Zoonoses Public Health 2019; 66:487-494. [PMID: 31090193 DOI: 10.1111/zph.12582] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 11/26/2018] [Accepted: 04/14/2019] [Indexed: 11/29/2022]
Abstract
Brucellosis is a widespread zoonotic disease considered as an emerging and re-emerging disease with a resulting threat of public health and animal health. Official reports document an animal incidence in Kazakhstan of about 0.6% per year, and the country still registers high number of human cases annually . The main objective of this paper was to evaluate the distribution and economic impact of brucellosis in Kazakhstan. We analysed human disease incidence data obtained from the Government Sanitary & Epidemiological Service with the aim to estimate the burden of disease in terms of disability-adjusted life years (DALYs). We also estimated the economic impact in terms of monetary losses. Additionally, we mapped the geographical distribution of the disease throughout Kazakhstan. In total, 1,334 human cases of brucellosis were registered in 2015 in Kazakhstan that resulted in 713 DALYs. Around $21 million was spent on compensation for animals that had to be slaughtered due to brucellosis, and an additional $24 million was spent on testing animals. Animal brucellosis and human brucellosis occur throughout the whole country, some trends of which are reviewed in this paper. We estimated the burden of the disease and explored possible explanation for high human incidence rates. This paper is the first to estimate the human burden of disease and the economic costs in Kazakhstan. Both of these are substantial.
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Affiliation(s)
- Duriya Charypkhan
- Kazakh Research - Scientific Veterinary Institute LLP, Almaty, Kazakhstan.,Kazakh National Agrarian University, Almaty, Kazakhstan
| | | | - Nikolay P Ivanov
- Kazakh Research - Scientific Veterinary Institute LLP, Almaty, Kazakhstan
| | - Sholpan A Baramova
- Kazakh Research - Scientific Veterinary Institute LLP, Almaty, Kazakhstan
| | | | - Paul R Torgerson
- Section of Veterinary Epidemiology, University of Zürich, Zürich, Switzerland
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Bosilkovski M, Siskova D, Spasovska K, Vidinic I, Dimzova M. The influence of illness duration before diagnosis on clinical characteristics and outcome in human brucellosis. Trop Doct 2019; 49:177-181. [PMID: 31060447 DOI: 10.1177/0049475519846422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our study assesses the influence of illness duration before establishing the diagnosis of brucellosis and initiating therapy on patients' main clinical characteristics and outcome in an endemic area. The medical files of 297 patients with brucellosis were retrospectively analysed. They were divided into four groups according to illness duration before initiating therapy: <10 days; 11-30 days; 31-90 days; and >90 days. There were significant differences in the occurrences of fever (P = 0.019), focal forms (P = 0.026), spondylitis (P = 0.034) and therapeutic failures (P = 0.006) between the groups. Duration of >30 days before treatment initiation is responsible for more serious clinical presentation and outcome, whereas illness duration of >90 days further worsens the clinical progression in human brucellosis.
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Affiliation(s)
- Mile Bosilkovski
- 1 Specialist in Infectious Diseases, University Hospital for Infectious Diseases and Febrile Conditions, Medical Faculty, Skopje, Republic of North Macedonia
| | - Dijana Siskova
- 2 Specialist in Infectious Diseases, Department for Infectious Diseases, Medical Center Shtip, Republic of North Macedonia
| | - Katerina Spasovska
- 1 Specialist in Infectious Diseases, University Hospital for Infectious Diseases and Febrile Conditions, Medical Faculty, Skopje, Republic of North Macedonia
| | - Ivan Vidinic
- 1 Specialist in Infectious Diseases, University Hospital for Infectious Diseases and Febrile Conditions, Medical Faculty, Skopje, Republic of North Macedonia
| | - Marija Dimzova
- 1 Specialist in Infectious Diseases, University Hospital for Infectious Diseases and Febrile Conditions, Medical Faculty, Skopje, Republic of North Macedonia
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Brucella Seroprevalence in a High-Risk Population in Greece: A Cross-Sectional Study. Interdiscip Perspect Infect Dis 2018; 2018:8751921. [PMID: 30675154 PMCID: PMC6323493 DOI: 10.1155/2018/8751921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction Brucellosis is a zoonosis with high occupational risk. However, seroprevalence of Brucella antibodies among occupational groups is not known, since studies in endemic countries are rare. Methods A cross-sectional seroprevalence study was conducted among livestock farmers in an endemic region in Greece. A low-risk group of individuals that just moved in the region was used as controls. Rose Bengal, Wright standard tube agglutination (STA) tests, and specific IgG and IgM antibodies using ELISA were evaluated; differences and odds ratios were calculated. Results were compared with studies from other endemic regions. Results 100 livestock farmers and family members and 34 first-year students were enrolled. Rose Bengal results were 18% positive versus 0% (p=0.007); Wright STAs for Brucella melitensis were 8% versus 2.9% (p=0.448) and for Brucella abortus they were 2% versus 2.9% (p=0.588). ELISA IgG was positive in 8% of farmers versus 2.9% of students (p=0.448). Parallel testing with Rose Bengal and ELISA IgG was positive in 3% versus 0% (p=0.571). No significant odds ratios were calculated for Wright STAs and ELISA IgG. Conclusions Healthy livestock farmers may present with positive Rose Bengal test but this translates to true seroprevalence in only a small proportion. Livestock farmers have no significant seroprevalence that may obscure diagnosis of acute brucellosis in clinical settings.
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Migisha R, Dan Nyehangane, Boum Y, Page AL, Zúñiga-Ripa A, Conde-Álvarez R, Bagenda F, Bonnet M. Prevalence and risk factors of brucellosis among febrile patients attending a community hospital in south western Uganda. Sci Rep 2018; 8:15465. [PMID: 30337685 PMCID: PMC6194062 DOI: 10.1038/s41598-018-33915-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/07/2018] [Indexed: 11/08/2022] Open
Abstract
Human brucellosis, a chronic disease contracted through contact with animals and consuption of unpasteurized dairy products is underreported in limited-resource countries. This cross-sectional study aimed to determine the prevalence and risk factors of brucellosis among febrile patients attending a community hospital in South western Uganda. A questionnaire that captured socio-demographic, occupational and clinical data was administered. Blood samples were tested for Brucella antibodies using Rose Bengal Plate Test (RBPT) and blood culture with standard aerobic BACTEC bottle was done. Of 235 patients enrolled, prevalence of brucellosis (RBPT or culture confirmed) was 14.9% (95% CI 10.6-20.1) with a culture confrmation in 4.3% of the participants. The factors independently associated with brucellosis were consumption of raw milk (aOR 406.15, 95% CI 47.67-3461.69); history of brucellosis in the family (aOR 9.19, 95% CI 1.98-42.54); and selling hides and skins (aOR 162.56, 95% CI 2.86-9256.31). Hepatomegaly (p < 0.001), splenomegaly (p = 0.018) and low body mass index (p = 0.032) were more common in patients with brucellosis compared to others. Our findings reveal a high prevalence of brucellosis among febrile patients and highlight a need for implementing appropiate tests, public awareness activities and vaccination of animals to control and eliminate the disease.
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Affiliation(s)
- Richard Migisha
- Mbarara University of Science and Technology (MUST), Mbarara, Uganda.
| | | | - Yap Boum
- Mbarara University of Science and Technology (MUST), Mbarara, Uganda
- Epicentre, Paris, France
| | | | - Amaia Zúñiga-Ripa
- Institute for Tropical Health, University of Navarra (ISTUN), Pamplona, Spain
| | | | - Fred Bagenda
- Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Maryline Bonnet
- Epicentre, Paris, France
- IRD UMI233/, INSERM U1175, Montpellier, France
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Investigating the Epidemiologic, Laboratory, and Clinical Features of Brucellosis Patients Hospitalized in the North of Iran During 2009 - 2014. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2018. [DOI: 10.5812/archcid.61012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Brucellosis remains the most common bacterial zoonotic infection in many countries worldwide. Despite being long recognized and controllable, the disease still causes substantial morbidity, affecting especially the young population. The aim of this review is to provide insight to the epidemiology, etiology, clinical features, diagnosis, and management of childhood brucellosis.
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Affiliation(s)
- Elham E Bukhari
- Infectious Disease Section, Department of Pediatrics, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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García Casallas JC, Villalobos Monsalve W, Arias Villate SC, Fino Solano IM. Acute liver failure complication of brucellosis infection: a case report and review of the literature. J Med Case Rep 2018. [PMID: 29519244 PMCID: PMC5844122 DOI: 10.1186/s13256-018-1576-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background Brucellosis is one of the most widespread zoonoses worldwide. It can affect any organ system, particularly the gastrointestinal system, but there is no report of acute liver failure as a brucellosis complication. Case presentation We present a case of acute liver failure secondary to brucellosis infection. A 75-year-old Hispanic man presented to a University Hospital in Chía, Colombia, with a complaint of 15 days of fatigue, weakness, decreased appetite, epigastric abdominal pain, jaundice, and 10 kg weight loss. On examination in an emergency room, abdomen palpation was normal with hepatosplenomegaly and the results of a liver function test were elevated. The diagnosis of brucellosis was confirmed by epidemiological contact and positive Rose Bengal agglutination with negative enzyme-linked immunosorbent assay immunoglobulin M for Brucella. He was then treated with doxycycline plus trimethoprim/sulfamethoxazole, with a favorable clinical outcome. Conclusions The clinical presentation of brucellosis can be very imprecise because it can affect any organ system; however, there is no report of acute liver failure as a brucellosis complication. This is the first reported case in the Colombian literature of acute liver failure due to brucellosis. We found this case to be of interest because it could be taken into account for diagnosis in future appearances and we described adequate treatment and actions to be taken at presentation.
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Affiliation(s)
- Julio César García Casallas
- Internal Medicine and Clinical Pharmacology, Department of Clinical Pharmacology and Therapeutics, Clínica Universidad de La Sabana, Chía, Colombia. .,Pharmacology Department, University of La Sabana, Chía, Colombia. .,Universidad El Bosque, Chía, Colombia. .,Research Group Therapeutic Evidence, University of La Sabana, Chía, Colombia.
| | | | | | - Ingrid Marisol Fino Solano
- Clinical Pharmacology Resident, Clinical Pharmacology Department, University of La Sabana, Chía, Colombia
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Zhao F, Koo B, Liu H, Eun Jin C, Shin Y. A single-tube approach for in vitro diagnostics using diatomaceous earth and optical sensor. Biosens Bioelectron 2018; 99:443-449. [PMID: 28818785 PMCID: PMC7127695 DOI: 10.1016/j.bios.2017.08.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/03/2017] [Accepted: 08/11/2017] [Indexed: 12/20/2022]
Abstract
Versatile, simple and efficient sample preparation is desirable for point-of-care testing of emerging diseases such as zoonoses, but current sample preparation assays are insensitive, labour-intensive and time-consuming and require multiple instruments. We developed a single-tube sample preparation approach involving direct pathogen enrichment and extraction from human specimens using diatomaceous earth (DE). Amine-modified DE was used to directly enrich a zoonotic pathogen, Brucella, in a large sample volume. Next, a complex of amine-modified DE and dimethyl suberimidate was used for nucleic acid extraction from the enriched pathogen. Using our single-tube approach, the pathogen can be enriched and extracted within 60min at a level of 1 colony formation unit (CFU) from a 1ml sample volume in the same tube. The performance of this approach is 10-100 times better than that of a commercial kit (102 to 103CFU/ml) but does not require a large centrifuge. Finally, we combined the single-tube approach with a bio-optical sensor for rapid and accurate zoonotic pathogen detection in human urine samples. Using the combination system, Brucella in human urine can be efficiently enriched (~ 8-fold) and the detection limit is enhanced by up to 100 times (1CFU/ml bacteria in urine) compared with the commercial kit. This combined system is fast and highly sensitive and thus represents a promising approach for disease diagnosis in the clinical setting.
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Affiliation(s)
- Fei Zhao
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, and Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - Bonhan Koo
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, and Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - Huifang Liu
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, and Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - Choong Eun Jin
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, and Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea
| | - Yong Shin
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, and Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, 88 Olympicro-43gil, Songpa-gu, Seoul, Republic of Korea.
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Zhang LB, Lin XW, Zhang SM, Li YX. Characteristics of liver function in brucellosis patients with liver injury: A retrospective evaluation of 254 cases. Shijie Huaren Xiaohua Zazhi 2017; 25:271-275. [DOI: 10.11569/wcjd.v25.i3.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To summarize the characteristics of liver function in brucellosis patients with liver injury.
METHODS The clinical and laboratory data of 254 brucellosis patients with liver injury treated at the First Hospital of Jilin University were retrospectively evaluated.
RESULTS The age of the 254 patients ranged from 2 to 80 years. All of the patients were diagnosed according to the 2012 brucellosis guidelines. Among the 254 patients, the majority had an increase in alanine transaminase (ALT) and aspartate transaminase (AST) levels < 3 times, an increase in γ-glutamyl transferase > 3 times, slightly elevated alkaline phosphatase, and normal total bilirubin. The disease duration was shorter in the abnormal liver function group than in the normal liver function group, but the highest temperature was higher in the abnormal liver function group. All patients were treated according to the World Health Organization recommendations. The time to fever relief in the two groups had no significant difference, but white blood cells, C-reactive protein, and erythrocyte sedimentation rate were higher in patients with normal liver function than in those without. Of 31 patients with abnormal liver function who were followed, no treatment failure occurred, but five had relapse. In the 44 patients with normal liver function who were randomly followed, three had treatment failure and six had recurrence. There was no significant difference between the two groups in the recurrence rate (P = 0.764). Total bilirubin was higher in patients with viral hepatitis than in those without.
CONCLUSION Brucella infection can cause varying degrees of liver dysfunction, and ALT or AST increase is usually not more than 3 times. Occasionally, patients may develop severe liver injury, but systemic inflammatory is slight. After a short period of treatment, liver function returns to normal in most cases. Liver injury is more severe in those also having viral hepatitis.
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Gündüz T, Tektürk PT, Yapıcı Z, Kürtüncü M, Somer A, Törün SH, Eraksoy M. Characteristics of isolated spinal cord involvement in neurobrucellosis with no corresponding MRI activity: A case report and review of the literature. J Neurol Sci 2016; 372:305-306. [PMID: 28017234 DOI: 10.1016/j.jns.2016.11.076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Tuncay Gündüz
- Department of Neurology and Child Neurology, Istanbul Faculty of Medicine, Istanbul University, Fatih/Capa, 34093 Istanbul, Turkey.
| | - Pınar Topaloğlu Tektürk
- Department of Neurology and Child Neurology, Istanbul Faculty of Medicine, Istanbul University, Fatih/Capa, 34093 Istanbul, Turkey.
| | - Zuhal Yapıcı
- Department of Neurology and Child Neurology, Istanbul Faculty of Medicine, Istanbul University, Fatih/Capa, 34093 Istanbul, Turkey.
| | - Murat Kürtüncü
- Department of Neurology and Child Neurology, Istanbul Faculty of Medicine, Istanbul University, Fatih/Capa, 34093 Istanbul, Turkey.
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Fatih/Capa, 34093 Istanbul, Turkey.
| | - Selda Hançerli Törün
- Department of Pediatric Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Fatih/Capa, 34093 Istanbul, Turkey
| | - Mefkure Eraksoy
- Department of Neurology and Child Neurology, Istanbul Faculty of Medicine, Istanbul University, Fatih/Capa, 34093 Istanbul, Turkey.
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Liu J, Kaul B, Shioleno A, Mehta N, Mejia R. Brucellosis Prostatitis: A Neglected Diagnosis for a Tropical Disease. CURRENT TROPICAL MEDICINE REPORTS 2016. [DOI: 10.1007/s40475-016-0089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Moosazadeh M, Nikaeen R, Abedi G, Kheradmand M, Safiri S. Epidemiological and Clinical Features of People with Malta Fever in Iran: A Systematic Review and Meta-Analysis. Osong Public Health Res Perspect 2016; 7:157-67. [PMID: 27413646 PMCID: PMC4927669 DOI: 10.1016/j.phrp.2016.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/15/2016] [Accepted: 04/20/2016] [Indexed: 11/14/2022] Open
Abstract
Objectives Numerous studies have reported the epidemiological and clinical features of Malta fever incidence in Iran. Review and synthesis of the related literature through meta-analysis can provide an appropriate measurement for aforementioned indices. Therefore, the present study aimed to determine the epidemiological and clinical features of people with Malta fever in Iran. Methods The required documents were obtained through searching national and international databases. In each study, standard deviation of the indices was calculated using binomial distribution formulas. Finally, the heterogeneity index was determined between studies using Cochran (Q) and I2 tests. Results Combining the results of 47 articles in the meta-analysis indicated that 57.6% (55.02–60.1%) and 42.3% (49.8–44.9%) of the patients were male and female, respectively. Most of the patients lived in rural areas; 68.4% (63.6–73.2%) compared to 31.4% (26.7–36.3%). In addition, 20.8% (17.4–24.2%) of the patients were ranchers and farmers, 16.9% (14.5–19.4%) were students, and 31.6% (27–36.2%) were housewives. Of the patients studies, 50.5% (35.6–65.2%) experienced contact with animals and 57.1% (46.4–67.9%) used unpasteurized dairy products. Fever, joint pain, and sweating were detected among 65.7% (53.7–77.8%) and 55.3% (44.4–66.2%), respectively. Conclusion The present study revealed that the frequency of male patients with brucellosis was considerably more than that of female patients. The number of patients with Malta fever in rural areas was significantly more than in urban areas. High-risk behavior, unprotected contact with animals, and using unpasteurized dairy products were among the most significant factors affecting Malta fever incidence in Iran. Fever, joint pain, and sweating were detected among most of the patients with Malta fever.
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Affiliation(s)
- Mahmood Moosazadeh
- Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roja Nikaeen
- Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghasem Abedi
- Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Saeid Safiri
- Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
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Bosilkovski M, Kamiloski V, Miskova S, Balalovski D, Kotevska V, Petrovski M. Testicular infection in brucellosis: Report of 34 cases. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2016; 51:82-87. [PMID: 27036087 DOI: 10.1016/j.jmii.2016.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/09/2015] [Accepted: 02/01/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND/PURPOSE To present clinical and laboratory features, treatment options, and outcome in patients with brucellar testicular infection and to compare them with analogous in brucellar patients without testicular involvement. METHODS Thirty four brucellar patients with testicular infection treated in two general hospitals in the Republic of Macedonia, during the period 1998-2009, were retrospectively analyzed. Their clinical and laboratory characteristics were compared with analogous in 364 male brucellar patients without testicular infection, who were treated at the same hospitals during the same time period. RESULTS Brucellar testicular infection was evident in 34 (8.5%) out of 398 male patients with brucellosis. The median age of the patients was 46.5 years. In all patients testicular involvement was presented as an acute form with a median duration of 5 days (range, 2-14 days) prior to diagnosis. Twenty-three of the patients had at least one other simultaneous focal infection. After starting with the treatment testicular infection lasted a median 10 days, range 7-21 days. Brucellar patients with testicular infection when compared with other brucellar patients more frequently manifested fever (97% vs. 61%), concomitant spondylitis (32% vs. 16%), and urinary system involvement (12% vs. 2%). Also, the relapse rate in patients with testicular involvement was significantly higher (24% vs. 9%). CONCLUSION In endemic regions brucellosis should be taken into consideration in any patient with testicular infection. Brucellar testicular involvement is usually characterized with a severe acute clinical presentation and a high percentage of relapses which entails the need of timely recognition and proper treatment duration of at least 60 days.
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Affiliation(s)
- Mile Bosilkovski
- Medical Faculty "Ss Cyril and Methodius University", Skopje, Macedonia.
| | - Viktor Kamiloski
- Medical Faculty "Ss Cyril and Methodius University", Skopje, Macedonia
| | - Silvana Miskova
- Department for Infectious Diseases, Medical Center, Veles, Macedonia
| | - Danco Balalovski
- Department for Infectious Diseases, Medical Center, Bitola, Macedonia
| | - Vesna Kotevska
- Medical Faculty "Ss Cyril and Methodius University", Skopje, Macedonia; Institute for Clinical Microbiology, Skopje, Macedonia
| | - Mile Petrovski
- Medical Faculty "Ss Cyril and Methodius University", Skopje, Macedonia
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Bosilkovski M, Zezoski M, Siskova D, Miskova S, Kotevska V, Labacevski N. Clinical characteristics of human brucellosis in patients with various monoarticular involvements. Clin Rheumatol 2016; 35:2579-84. [PMID: 26861030 DOI: 10.1007/s10067-016-3207-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/20/2015] [Accepted: 02/01/2016] [Indexed: 12/22/2022]
Abstract
The aim of the study was to determine the main demographic, epidemiological, clinical characteristics, and outcome in patients with various types of brucellar monoarticular involvement. Retrospectively, we analyzed medical histories of 331 patients with brucellar monoarticular involvement who were treated at the infectious diseases departments in Prilep, Shtip, and Veles, Republic of Macedonia, during the period 1990-2012. Their data were compared accordingly to the affected joint (sacroiliac, hip, knee, ankle, wrist, and shoulder).Patients with shoulder arthritis were significantly the oldest (mean ± standard deviation [SD] 46.0 ± 14.5 years) whereas sacroiliitis and hip arthritis were present predominantly in younger patients (mean ± SD 28.7 ± 14.1 and 28.3 ± 18.3 years, respectively) (p = 0.014). Shoulder arthritis duration was significantly the longest (mean ± SD 24.5 ± 12.4 days), and wrist arthritis duration was significantly the shortest (mean ± SD 4.1 ± 2.5 days) (p < 0.001), before establishing the diagnosis of brucellosis. With appropriate treatment, the need for restitution of the joint impairment was significantly longer when sacroiliitis and hip arthritis were present (mean ± SD 32.8 ± 23.0 and 24.6 ± 12.5 days, respectively) (p < 0.001). The relapses were noted in 14.5, 14, 16.5, 5.5, 6, and 5.5 % of the patients with sacroiliitis, hip-, shoulder-, knee-, ankle-. and wrist arthritis, respectively. In endemic areas, brucellosis should be included in the differential diagnostic consideration in patients with monoarticular involvement. Knee-, ankle-, and wrist arthritis seem to be more benign and with appropriate treatment result in short duration and satisfactory outcome. On the other hand, the involvement of sacroiliac, hip-, and shoulder joint deserves more serious approach due to longer arthritis duration and higher frequency of relapses.
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Affiliation(s)
- Mile Bosilkovski
- Medical Faculty "Ss Cyril and Methodius" University, ul "Bozidar Adzija" br. 18/1-6 1000, Skopje, Republic of Macedonia.
| | - Marjan Zezoski
- Department for Infectious Diseases, Medical Center Prilep, Prilep, Republic of Macedonia
| | - Dijana Siskova
- Department for Infectious Diseases, Medical Center Shtip, Shtip, Republic of Macedonia
| | - Silvana Miskova
- Department for Infectious Diseases, Medical Center Veles, Veles, Republic of Macedonia
| | - Vesna Kotevska
- Medical Faculty "Ss Cyril and Methodius" University, ul "Bozidar Adzija" br. 18/1-6 1000, Skopje, Republic of Macedonia
- Institute for Microbiology, Skopje, Republic of Macedonia
| | - Nikola Labacevski
- Medical Faculty "Ss Cyril and Methodius" University, ul "Bozidar Adzija" br. 18/1-6 1000, Skopje, Republic of Macedonia
- Institute for Clinical Pharmacology, Skopje, Republic of Macedonia
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Bosilkovski M, Krteva L, Caparoska S, Labacevski N, Petrovski M. Childhood brucellosis: Review of 317 cases. ASIAN PAC J TROP MED 2015; 8:1027-1032. [PMID: 26706674 DOI: 10.1016/j.apjtm.2015.11.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 10/20/2015] [Accepted: 11/03/2015] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe the main epidemiological, clinical, and laboratory features, treatment options and outcome in children with brucellosis. METHODS Retrospectively evaluated data were obtained from 317 pediatric patients with brucellosis that were treated at the University Clinic for Infectious Diseases and Febrile Conditions in Skopje, during the period from 1989 to 2011. The medical records and follow-up protocols were used for evaluation. RESULTS Childhood brucellosis composed 317 (18.7%) of 1691 patients with brucellosis. The patients were median 9 years old, ranging from 7 months to 14 years, and 201 (63.4%) were males. Family history was present in 197 (62.1%), and direct contact with animals occurred in 140 (44.2%) of the children. The dominant manifestations were fever in 248 (78.2%), joint pain in 228 (71.9%) and hepatomegaly in 216 (68.1%). Organ affection was present in 206 (65.0%) of the patients. One hundred and six (33.4%) of the patients were treated with combination composed of two, and 211 (66.6%) with three antimicrobial agents. Relapses were registered in 21 (6.6%), and therapeutic failures in 3 (0.9%) of the children. CONCLUSIONS In endemic regions childhood brucellosis represents a significant part of human cases. Wide spectrum of clinical manifestations, frequent affection of various organ systems and possibility of relapses show that brucellosis could be a serious disease in this age group. The presence of fever, joint pain, sweating, and affection of various systems in children from endemic regions should alert pediatricians for the possibility of brucellosis.
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Affiliation(s)
- Mile Bosilkovski
- Medical Faculty, 'Ss Cyril and Methodius' University, Skopje, Macedonia.
| | - Ljiljana Krteva
- University Clinic for Infectious Diseases and Febrile Conditions, Skopje, Macedonia
| | - Sonja Caparoska
- University Clinic for Infectious Diseases and Febrile Conditions, Skopje, Macedonia
| | - Nikola Labacevski
- Medical Faculty, 'Ss Cyril and Methodius' University, Skopje, Macedonia; Institute for Clinical Pharmacology, Skopje, Macedonia
| | - Mile Petrovski
- Medical Faculty, 'Ss Cyril and Methodius' University, Skopje, Macedonia; University Clinic for Pediatric Surgery, Skopje, Macedonia
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Kawano-Dourado L, Peirera DAS, Kawassaki ADM, Dolhnikoff M, Silva MVD, Kairalla RA. Lymphadenopathy and fever in a chef during a stay in Europe. ACTA ACUST UNITED AC 2015; 41:191-5. [PMID: 25909155 PMCID: PMC4428857 DOI: 10.1590/s1806-37132015000004412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 10/29/2014] [Indexed: 11/22/2022]
Abstract
This case illustrates a rare presentation (as lymphadenopathy and fever) of one of the most common zoonotic diseases worldwide--brucellosis--in a 22-year-old Brazilian male (a chef) who had recently returned to Brazil after having lived in and traveled around Europe for one year. The histopathology, clinical history, and response to treatment were all consistent with a diagnosis of brucellosis, which was confirmed by PCR in a urine sample. We also review some aspects of brucellosis, such as the clinical features, diagnosis, and management.
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Affiliation(s)
| | | | | | - Marisa Dolhnikoff
- Department of Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
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Chegeni AS, Ezatpour B, Saki M, Mokhayeri H, Adavi S, Nasiri E, Azami M. Seroepidemiology of human brucellosis in nomads in a rural area of Iran. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2014. [DOI: 10.1016/s2222-1808(14)60584-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Moreno E. Retrospective and prospective perspectives on zoonotic brucellosis. Front Microbiol 2014; 5:213. [PMID: 24860561 PMCID: PMC4026726 DOI: 10.3389/fmicb.2014.00213] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 04/23/2014] [Indexed: 11/13/2022] Open
Abstract
Members of the genus Brucella are pathogenic bacteria exceedingly well adapted to their hosts. The bacterium is transmitted by direct contact within the same host species or accidentally to secondary hosts, such as humans. Human brucellosis is strongly linked to the management of domesticated animals and ingestion of their products. Since the domestication of ungulates and dogs in the Fertile Crescent and Asia in 12000 and 33000 ya, respectively, a steady supply of well adapted emergent Brucella pathogens causing zoonotic disease has been provided. Likewise, anthropogenic modification of wild life may have also impacted host susceptibility and Brucella selection. Domestication and human influence on wild life animals are not neutral phenomena. Consequently, Brucella organisms have followed their hosts’ fate and have been selected under conditions that favor high transmission rate. The “arm race” between Brucella and their preferred hosts has been driven by genetic adaptation of the bacterium confronted with the evolving immune defenses of the host. Management conditions, such as clustering, selection, culling, and vaccination of Brucella preferred hosts have profound influences in the outcome of brucellosis and in the selection of Brucella organisms. Countries that have controlled brucellosis systematically used reliable smooth live vaccines, consistent immunization protocols, adequate diagnostic tests, broad vaccination coverage and sustained removal of the infected animals. To ignore and misuse tools and strategies already available for the control of brucellosis may promote the emergence of new Brucella variants. The unrestricted use of low-efficacy vaccines may promote a “false sense of security” and works towards selection of Brucella with higher virulence and transmission potential.
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Affiliation(s)
- Edgardo Moreno
- Programa de Investigación en Enfermedades Tropicales, Escuela de Medicina Veterinaria, Universidad Nacional Heredia, Costa Rica ; Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica San José, Costa Rica
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Ozturk-Engin D, Erdem H, Gencer S, Kaya S, Baran AI, Batirel A, Tekin R, Celen MK, Denk A, Guler S, Ulug M, Turan H, Pekok AU, Mermut G, Kaya S, Tasbakan M, Tulek N, Cag Y, Inan A, Yalci A, Ataman-Hatipoglu C, Gonen I, Dogan-Celik A, Bozkurt F, Gulsun S, Sunnetcioglu M, Guven T, Duygu F, Parlak E, Sozen H, Tosun S, Demirdal T, Guclu E, Karabay O, Uzun N, Gunal O, Diktas H, Haykir-Solay A, Erbay A, Kader C, Aydin O, Erdem A, Elaldi N, Kadanali A, Yulugkural Z, Gorenek L, Altındis M, Bolukcu S, Agalar C, Ormeci N. Liver involvement in patients with brucellosis: results of the Marmara study. Eur J Clin Microbiol Infect Dis 2014; 33:1253-62. [PMID: 24557334 DOI: 10.1007/s10096-014-2064-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 01/20/2014] [Indexed: 12/27/2022]
Abstract
Brucellosis is a zoonotic disease that primarily affects the reticuloendothelial system. But, the extent of liver damage in due course of the disease is unclear. This study included 325 brucellosis patients with significant hepatobiliary involvement identified with microbiological analyses from 30 centers between 2000 and 2013. The patients with ≥5 times of the upper limit of normal for aminotransferases, total bilirubin level ≥2 mg/dl or local liver lesions were enrolled. Clinical hepatitis was detected in 284 patients (87.3 %) and cholestasis was detected in 215 (66.1 %) patients. Fatigue (91 %), fever (86 %), sweating (83 %), arthralgia (79 %), and lack of appetite (79 %) were the major symptoms. Laboratory tests showed anemia in 169 (52 %), thrombocytopenia in 117 (36 %), leukopenia in 81 (25 %), pancytopenia in 42 (13 %), and leukocytosis in 20 (6 %) patients. The most commonly used antibiotic combinations were doxycycline plus an aminoglycoside (n = 73), doxycycline plus rifampicin (n = 71), doxycycline plus rifampicin and an aminoglycoside (n = 27). The duration of ALT normalization differed significantly in three treatment groups (p < 0.001). The use of doxycycline and an aminoglycoside in clinical hepatitis showed better results compared to doxycycline and rifampicin or rifampicin, aminoglycoside, doxycycline regimens (p < 0.05). However, the length of hospital stay did not differ significantly between these three combinations (p > 0.05). During the follow-up, treatment failure occurred in four patients (1 %) and relapse was seen in three patients (0.9 %). Mortality was not observed. Hepatobiliary involvement in brucellosis has a benign course with suitable antibiotics and the use of doxycycline and an aminoglycoside regimen seems a better strategy in select patients.
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Affiliation(s)
- D Ozturk-Engin
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Zdravkovska M, Stojmanovski Z, Taleski V, Jovevska S, Markovski V. Public Health Aspects of Human Brucellosis in the Republic of Macedonia. Open Access Maced J Med Sci 2013. [DOI: 10.3889/oamjms.2013.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: The Republic of Macedonia is an endemic area where brucellosis is a dominant zoonosis with high morbidity and enormous economic loss.Aim: To determine the incidence rate, prevalence rate and development tendency of infected people with brucellosis in R. Macedonia in the period from 01.01.1999 to 31.12.2009, to register and analyse the epidemiological characteristics of the infected with brucellosis according to gender, age and regional distribution.Materials and methods: The data about the infected people with brucellosis were taken from the register of individual cases as well as monthly and annual reports for infectious diseases prepared by the Institute for Public Health of Republic of Macedonia.Results:Â According to the survey the highest number of incidence of human brucellosis in R. Macedonia was found in 2008, 23.94/100,000 people, and the lowest number of infected people was in 2009, about 13.99/100,000 people. Human brucellosis has a decreasing tendency.Conclusion: Human brucellosis remains a public health problem in Republic of Macedonia.
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Kassiri H, Amani H, Lotfi M. Epidemiological, laboratory, diagnostic and public health aspects of human brucellosis in western Iran. Asian Pac J Trop Biomed 2013; 3:589-94; discussion 593-4. [PMID: 23905014 DOI: 10.1016/s2221-1691(13)60121-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 07/20/2013] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine brucellosis's epidemiologic, laboratory, diagnostic and public health features considering brucellosis is endemic in Azna County, western Iran. METHODS This descriptive cross-sectional study was investigated on 43 patients with brucellosis in Azna County. The subjects were the patients with symptoms correspondent with brucellosis and positive Wright and 2ME tests. A questionnaire about demographic, epidemiological and laboratory findings was filled in. Afterwards, patients were treated using usual antimicrobial drugs regimen. The collected data were analyzed by SPSS software version 16. RESULTS Forty-three subjects were found to be positive in laboratory tests. Incidence of Brucellosis was 59.31 per hundred thousand population. About 34.9% of patients were female and 65.1% male. Nearly 95.2 % of human cases were living in rural and 4.8 % in urban areas. Around 20.9% of patients had history of animal contact. The commonest transmission was unpasteurized dairy products (79.1%). The most contagious seasons were summer and spring (60.3%). The most common age group was 15-24 (27.9%), and about 60.5% of the patients were between 15-44 years old. Disease was more common among housewives (30.2%) and farmers (20.9%). The majority of the patients had Wright test titre=1:320 (54.1%) and 2ME test titre=1:160 (56.1%) in serological titration. Doxycycline with Rifampin was used for treatment of the greatest of patients (60.4%). CONCLUSIONS In order to control this zoonotic disease, close cooperation of health and veterinary organizations is necessary.
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Affiliation(s)
- Hamid Kassiri
- Health School, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran.
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