Brucellosis in older person: a case report from Qatar

BACKGROUND

Brucellosis is a multisystem disease with a broad spectrum of non-specific symptoms that generally occur within three weeks but sometimes up to 3 months after inoculation. Human brucellosis is quite uncommon in Elderly in Qatar.

CASE REPORT

This report describes a case of Brucellosis in acute geriatric unit under Rumailah Hospital in Qatar. The patient was an 81-year-old Qatari Gentle man, functionally able to walk with minimal assistance and had mild cognitive impairment who presented with high-grade fever with chills, anorexia, low back pain and arthralgia for 10 days. The above complaints occurred often for 1 month and had fever intermittently. Lab investigations revealed as high CRP 117 mg/l, low Hb 9.1 g/dl and mild elevation in ALP (151 µ/l) with normal leukocyte and platelet count. His blood culture positive for Brucella melitensis with high brucella Antibody titter 1:1280. The diagnosis made as Brucellosis.

DISCUSSION

The clinical manifestations of Brucellosis are fever, night sweating, chills, arthralgia and loss of appetite. It seems pyrexia of unknown origin without other symptoms is most common presentation of Brucellosis in old age. The confirmation of Brucellosis made with serological tests, with significantly high titer, in the presence or absence of blood culture. Brucella antibody titers (≥1:160) are suggestive of active infection. Anemia and raised CRP and liver enzymes were the most prominent laboratory abnormalities in our patients. Previous study from Qatar reported that 41.7% had a history of raw milk consumption and 12.5% had a history of animal contact. The objectives of Brucellosis treatment include the prevention of complications and relapse.

CONCLUSION

Our case presented with classical symptoms and received appropriate treatment on time. However, atypical clinical presentation and lack of specific history taking can delay diagnosis and treatment; it leads to serious clinical disease progression with increased complications. From this case study, we would contribute to optimal assessment and to keep differential diagnosis for unknown cause of fever can be Brucellosis in geriatric population.

Fiber degradation and carbohydrate production by combined biological and chemical/physicochemical pretreatment methods of lignocellulosic biomass - A review

Sustainable biorefinery concepts based on lignocellulosic biomass are gaining worldwide research interest because of their inexpensiveness and abundance. The recalcitrance of lignocellulosic biomass poses a major hindrance to enhance biofuel production. Therefore, a pretreatment step is critical to prepare the substrates for the downstream process. Combining pretreatment steps help to lower the severity of the drawbacks of a single pretreatment step. This paper systematically reviews the combined biological and chemical/physicochemical pretreatment based on fiber degradation and sugar yield. An energy-efficient biological pretreatment method combined with a chemical pretreatment that accelerates the pretreatment times has been seen to be efficient for fiber degradation and sugar yields. However, fungal species, culture conditions, biomass type, the severity of chemical pretreatment and the order of sequential pretreatment influences the relative component contents and sugar yield. Even the same biomass from different sources undergoing similar pretreatment conditions could result in a varying amount of digestibility.

LamB-mediated adherence of enteropathogenic Escherichia coli to HEp-2 cells

AIMS

To establish the role of maltoporin (LamB) in adherence of enteropathogenic Escherichia coli (EPEC) to epithelial cells in vitro.

METHODS AND RESULTS

Three strains, wild type (WT) EPEC, a maltoporin (LamB) mutant DeltalamB, and DH5alpha were used to study adherence to cultured HEp-2 cells. Mutant DeltalamB was found to be deficient in adherence compared to WT EPEC. Adherence of DeltalamB was restored to wild type levels when complemented with the cloned lamB gene. The non-adherent strain DH5alpha also adhered to HEp-2 cells when it harboured the cloned lamB gene. The LamB protein was isolated from WT EPEC by electroelution and antibodies were raised in rabbits. The specificity of the antibodies was analysed by Western blotting. Anti-LamB antiserum reduced adherence of WT EPEC to HEp-2 cells. The LamB protein was coated on latex beads and the beads adhered to HEp-2 cells. Anti-LamB antiserum prevented bead adherence to HEp-2 cells. Multiple sequence alignment showed that the L9 loop of EPEC LamB had four amino acids different from the L9 loop of LamB from several other related pathogens.

CONCLUSIONS

LamB serves as an alternative or additional adherence factor for EPEC.

SIGNIFICANCE AND IMPACT OF THE STUDY

Adherence is an important component of the pathogenesis of noninvasive pathogens like EPEC. A putative adhesin such as LamB, which has already been found to be co-expressed with virulence factor EspB may be a potential vaccine candidate for control of EPEC and related pathogens.

Construction of intein-mediated hGMCSF expression vector and its purification in Pichia pastoris

As a novel attempt for the intracellular recombinant protein over expression and easy purification from Pichia pastoris, the therapeutic cytokine human granulocyte macrophage colony stimulating factor (hGMCSF) gene was fused to an intein-chitin-binding domain (gene from pTYB11 vector) fusion tag by overlap extension PCR and inserted into pPICZB vector, allowing for the purification of a native recombinant protein without the need for enzymatic cleavage. The fusion protein under the AOX1 promoter was integrated into the P. pastoris genome (SMD 1168) and the recombinant Pichia clones were screened for multicopy integrants. Expression of hGMCSF was done using glycerol and methanol based synthetic medium by three stage cultivation in a bioreactor. Purification of the expressed hGMCSF fusion protein was done after cell disruption and binding of the solubilized fusion protein to chitin affinity column, followed by DTT induced on column cleavage of hGMCSF from the intein tag. In this study, final biomass of 89 g dry cell weight/l and purified hGMCSF of 120 mg/l having a specific activity of 0.657 x 10(7) IU/mg was obtained. This strategy has an edge over the other--His or--GST based fusion protein purification where non-specific protein binding, expensive enzymatic cleavage and further purification of the enzyme is required. It distinguishes itself from all other purification systems by its ability to purify, in a single chromatographic step.

Production, purification and diagnostic application of filarial recombinant protein WbSXP-1 expressed in salt inducible Escherichia coli

Wuchereria bancrofti protein WbSXP-1 was identified and established as a potential candidate for the diagnosis of lymphatic filariasis. For the economic production of rWbSXP-1, osmotically (salt) inducible Escherichia coli GJ1158 was preferred. Cultivation and expression was optimized in 3 L airlift bioreactor (ALB) and was successfully extended to 30 L ALB. Purification of rWbSXP-1 his-tag protein was optimized in technical scale using FPLC and the maximal recovery of rWbSXP-1 with significant level of purity was achieved using the combination of IMAC and gel filtration. Quality criteria for immuno-reactivity of purified rWbSXP-1 were established for diagnostic applications. Enhancement of sensitivity in rapid diagnostic format was optimized to effectively detect weak to strong antibody reactivity in individuals exposed to lymphatic filariasis. Performance of the rapid format during field evaluation was successful. The accelerated stability assessment of the rapid format satisfied the requirements of WHO-cGMP norms. This investigation presents a successful technical scale production and purification of rWbSXP-1 considering the future industrial application and an enhanced rapid flow through antibody assay for the diagnosis of human lymphatic filariasis.

Glucose uptake kinetics of Saccharomyces cerevisiae monitored with a newly developed FIA

The glucose content of the culture liquid during shift experiments and synchronized cultures of Saccharomyces cerevisiae H1022 (ATCC 32167) was monitored using a greatly improved and highly precise FIA. During shift-up experiments on the dilution rate, an overshoot of the glucose-concentration was observed. The amplitude of the overshoot showed a dependency on the duration of undisturbed cultivation before application of the shift. Mutarotational non-equilibrium was excluded as the cause of the observed overshoot. For the first time glucose measurements of oscillating cultures of Saccharomyces cerevisiae are demonstrated with high accuracy and reproducibility. The data strongly support the proposals by Münch et al. (1992a, b) that faint oscillations in glucose concentration are responsible for the persistence of the synchronization. Analytical subsystems prove to be a powerful tool for investigation of the dynamics of metabolic pathways of microbial organisms. Accurate glucose measurements at low concentrations point out the limits and allow refinements of commonly used models.