Clinical manifestations and treatment outcomes of human brucellosis at a tertiary care center in Saudi Arabia

Traditional cheese consumption leading to hemodialysis induced by rifampin treatment: A case report

This case report details the journey of a 51-year-old man residing in a remote Iranian village, involved in livestock rearing, who was hospitalized due to Brucellosis contracted from consuming traditional cheese and dairy products. Initially treated with doxycycline and rifampin, complications arose during antituberculosis therapy, with the patient developing symptoms of nausea, vomiting, and edema alongside renal function deterioration necessitating medication cessation. Subsequent manifestations of proteinuria, toxic hepatitis, and nephrotic syndrome prompted renal biopsy, revealing drug-induced glomerular and tubular damage. Swift cessation of rifampicin, combined with prednisolone therapy, led to symptom amelioration, resulting in the cessation of dialysis and the patient's discharge within three weeks. This case underscores the intricate relationship between traditional cheese consumption, medication-induced renal complications, and the importance of timely intervention and appropriate management in achieving a successful patient outcome.

Co-delivery of doxycycline and rifampicin using CdTe-labeled poly (lactic-co-glycolic) acid for treatment of Brucella melitensis infection

Brucellosis poses a significant challenge in the medical field as a systemic infection with a propensity for relapse. This study presented a novel approach to brucellosis treatment, enhancing the efficacy of doxycycline and rifampicin through the use of poly (lactic-co-glycolic) acid coupled with cadmium-telluride quantum dots (Dox-Rif-PLGA@CdTe). The double emulsion solvent evaporation method was employed to prepare Dox-Rif-PLGA@CdTe. The study scrutinized the physicochemical attributes of these nanoparticles. The impact of antibiotic-loaded nanoparticles on Brucella melitensis was evaluated through well diffusion, minimum inhibitory concentration (MIC), and cell culture. The chemical analysis results demonstrated a possibility of chemical reactions occurring among the constituents of nanoparticles. Assessments using the well diffusion and MIC methods indicated that the impact of free drugs and nanoparticles on bacteria was equivalent. However, the drug-loaded nanoparticles significantly decreased the colony-forming units (CFUs) within the cell lines compared to free drugs. In conclusion, the synthesis of nanoparticles adhered to environmentally friendly practices and demonstrated safety. The sustained drug release over 100 h facilitated drug accumulation at the bacterial site, resulting in a heightened therapeutic effect on B. melitensis and improved outcomes in brucellosis treatment. The application of these synthesized nanodrugs exhibited promising therapeutic potential.

Infection of tendon sheaths, joints, bursae, soft tissue, and tendon rapture by brucella: A case report

Key Clinical Message

Arthritis is one of the main presentations of chronic brucellosis, but bursitis and tendon rupture are also caused by brucellosis. Therefore, brucellosis should be considered in the differential diagnosis of arthritis, bursitis, and tendon rupture by physicians. In addition, early diagnosis and treatment are very important in the prevention of disability.

Abstract

Brucellosis is a zoonotic disease common in the Middle East. Manifestations of acute disease are fever, sweating, myalgia, and arthralgia. However, bone joint involvement occurs in 10%-85% of patients, and sacroiliac involvement occurs in up to 80% and vertebral joint involvement in up to 54%. A 57-year-old woman was admitted to the hospital of Islamic Azad University on February 26, 2021, with a history of one-month pain and limited movement of the right shoulder joint with fever for surgery of the shoulder ligament. The standard agglutination titer (Wright) for brucellosis at first was 1/640 and then increased. MRI of the shoulder showed a supraspinatus tendon and anterosuperior labral of the glenoid labrum tear. Although the patient was a candidate for shoulder joint ligament surgery, with a diagnosis of brucellosis, the treatment of brucellosis was prescribed, symptoms disappeared with anti-brucellosis antibiotic therapy without surgery, and the patient recovered. Supraspinatus tendon and antero superior labral of glenoid labrum tear of the shoulder joint in brucellosis is generally very rare. Failure or delay in the treatment of brucellosis can cause ligament rupture or joint disability. Sometimes, there are no symptoms except osteoarticular manifestations in brucellosis; therefore, brucellosis should be one of the differential diagnoses in osteoarticular diseases.

Acute Brucella infection associated with splenic infarction: a case report and review of the literature

Brucella infection often involves multiple organ systems with non-specific clinical manifestations, and cutaneous involvement is uncommon. Splenic infarction and leukocytoclastic vasculitis also rarely occur together in the course of brucellosis infection. We report the case of a 47-year-old man with Brucella combined with splenic infarction. The patient presented with fever; large liver, spleen, and lymph nodes; muscle and joint pain; positive laboratory tests for blood cultures (Brucella abortus); and imaging suggestive of splenic infarction. After treatment with streptomycin, doxycycline, and rifampicin, the patient's clinical symptoms and splenic damage improved. Detailed history taking, correct interpretation of laboratory results, and knowledge of rare complications of human brucellosis facilitate early diagnosis and treatment of the disease.

Public Knowledge, Attitudes, and Practices Regarding Brucellosis in Taif City, Saudi Arabia

BACKGROUND

Brucellosis is a serious zoonotic infectious disease. Humans contract the disease by coming into contact with infected animals or their products. In Saudi Arabia, brucellosis is considered to be an endemic disease, with an annual incidence of 15.34 per 100,000 population from 2003 to 2018. Because of the devastating consequences for human health, raising awareness is an essential component in preventing brucellosis. Our study aims to assess the knowledge, awareness, and attitudes regarding brucellosis among the residents of Taif City, Saudi Arabia.

METHODS

A descriptive, cross-sectional survey conducted in June-October 2022 targeted the population of Taif City, Saudi Arabia. The data were collected by an online questionnaire, which included questions on sociodemographic characteristics, awareness regarding brucellosis, behavior and attitude toward animals, and consuming animal-based products.

RESULTS

A total of 743 participants were included. The participants were 18-70 years old, 63.4% were females, and 79.4% had a university education. Only 450 participants answered yes to the first question: "Do you know about brucellosis or have you heard about it?" Therefore, they were asked to answer knowledge questions. It was found that out of 450 participants, 46.9% demonstrated a "poor" knowledge level. Participants aged 26-55 years old demonstrated significantly more "good" knowledge than the other age groups (p = 0.001). Males demonstrated significantly more "good" knowledge (30.6%) than females (14.9%) (p < 0.001). The practices and attitudes of animal breeder participants (16.2%) were satisfactory because more than half of them did not participate in the birth of animals (53.4%), 50.7% did not participate in the birth with abortion, and approximately 61% used gloves when taking care of animals. The practices were unsatisfactory because 53.4% of the participants reported that they "always" eat the meat of animals they keep, and 64.4% reported that they personally slaughter sheep or cows from the herd.

CONCLUSION

Our study showed that most of the participants were aware of brucellosis; however, at the same time, the knowledge level regarding brucellosis was not satisfactory.

Co-Delivery of Doxycycline and Hydroxychloroquine Using CdTe-Labeled Solid Lipid Nanoparticles for Treatment of Acute and Chronic Brucellosis

Brucellosis is a systemic disease in both acute and chronic forms which can affect any organ or tissue in the body. One of the biggest issues in treating this disease is its relapse. In this study, a complete treatment of brucellosis was evaluated using enhanced performance of doxycycline and hydroxychloroquine drugs by using solid lipid nanoparticles (SLN) conjugated cadmium-telluride quantum dots. The double emulsion method was used to prepare SLN and cadmium-telluride quantum dots. The physicochemical properties of NPs were determined. The effect of nanoparticle-loaded antibiotics against Brucella melitensis was determined by well diffusion, minimum inhibitory concentration (MIC), cell culture, and animal studies. The means of particle size, PDI, zeta potential, drugs loading, and encapsulation efficiency were 214 ± 25 nm, 0.385 ± 0.022, −18.7 ± 2.3 mV, 17.7 ± 1.5%, and 94.15 ± 2.6%, respectively. The results of FTIR and DSC showed that no chemical reaction occurred between the components of the NPs. The effect of free drug and NPs on bacteria was the same by well diffusion and MIC method. Drug-loaded NPs significantly reduced the number of CFUs in the cell line and acute and chronic brucellosis compared to the free drug. In conclusion, the synthesized nanoparticles were safe and green. With the slow release of the drug (100 h), the accumulation of the drug at the bacterial site increases and causes a greater effect on the B. melitensis and improves the disease of brucellosis. The use of synthesized nanodrugs in this study had promising therapeutic results.