Bacteremic and Nonbacteremic Brucellosis: Clinical and Laboratory Observations

Kadanalı, Ayten; Özden, Kemalettin; Altoparlak, Ülkü; Ertürk, Ayşe; Parlak, Mehmet

doi:10.1007/s15010-008-7353-3

Cited by 29 publications

(28 citation statements)

References 15 publications

(24 reference statements)

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“…Bacteremia is an early event in the pathogenesis of Brucella infections, and isolation rates are much higher in acute cases presenting with symptomatic disease of less than 2 weeks [33]. Because bacteremic patients more often present with fever and chills than nonbacteremic patients [34], the recovery rate of brucellae can be improved through blood samples taken in the pyrexial phase. In acute brucellosis cases, the sensitivity of culturing Brucella spp.…”

Section: Isolation and Identification Of Brucella Spp From Clinical Samentioning

confidence: 99%

Implications of laboratory diagnosis on brucellosis therapy

Dahouk

Nöckler

2011

Expert Review of Anti-infective Therapy

162

131

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Brucellosis is one of the world's most widespread bacterial zoonoses, leading to tremendous economic losses in endemic regions and serious complaints in affected patients. The infection may be transmitted by direct animal contact, but is usually acquired through the consumption of contaminated food products of animal origin, mainly via unpasteurized goat's milk and cheese. Furthermore, brucellosis is the most common bacterial laboratory-acquired infection worldwide [1].Although many national and international programs have been established to eradicate the pathogen and control its spreading in animal husbandry, brucellosis is still a re-emerging disease. The surveillance of animal brucellosis is difficult due to bacterial persistence in wildlife and environmental reservoirs, with consecutive spill-over to domestic animals [2].Brucellosis is caused by members of the genus Brucella (B.), which are gram-negative, facultative intracellular coccobacilli that were historically differentiated by their preferred animal host, varying pathogenicity and a few selected phenotypic traits. The genus comprises six classical species: B. melitensis bv 1-3 (primarily isolated from sheep and goats); B. abortus bv 1-6 and 9 (from cattle and other Bovidae); B. suis bv 1-3 (from pigs), bv 4 (from reindeer), bv 5 (from small rodents); B. canis (from dogs); B. ovis (from sheep); and B. neotomae (from desert wood rats). Recently, two novel species of marine origin, B. pinnipedialis (isolated from seals) and B. ceti (from dolphins and whales) [3], B. microti isolated from the common vole (Microtus arvalis) [4], red foxes (Vulpes vulpes) [5] and from soil [6], and B. inopinata isolated from a breast implant wound of a 71-year-old female patient [7] have been described. In the past, a lot of atypical Brucella strains arose. These could represent novel species or lineages of already described species, for example various Brucella strains originating from wild native rodent species in North Queensland, Australia [8], a novel Brucella isolate in association with two cases of stillbirth in nonhuman primates [9], and a B. inopinata-like strain (BO2), which was isolated from a lung biopsy of a 52-year-old Australian patient suffering from chronic destructive pneumonia [10].Physicians' awareness of the infection is very poor in many countries, and most cases correctly identified are clinically advanced. Because of its protean clinical manifestations, human brucellosis can be easily confused with other infectious and noninfectious diseases, leading to diagnostic delays and late onset of therapy. The isolation of the fastidious organisms is often unsuccessful or takes a long time, which is why the presumptive clinical diagnosis is usually confirmed by Brucellosis is a worldwide zoonosis with a huge economic impact on animal husbandry and public health. The diagnosis of human brucellosis can be protracted because the disease primarily presents as fever of unknown origin with unspecific clinical signs and symptoms. The isolation rate of the fastidiou...

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Section: Isolation and Identification Of Brucella Spp From Clinical Samentioning

confidence: 99%

Implications of laboratory diagnosis on brucellosis therapy

Dahouk

Nöckler

2011

Expert Review of Anti-infective Therapy

162

131

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“…Brucellosis is diagnosed definitively via isolation of Brucella species from blood or tissue samples in a laboratory, however, isolation of bacteria is not always possible [4] . Isolation of Brucella from an abscess or biopsy material provides conclusive evidence of Brucella infection, but this is achieved in less than 25% of cases [5] .…”

Section: Dear Editormentioning

confidence: 99%

A Case of Brucellosis due to Brucella melitensis Isolated from Epidural Abscess

Karagöz¹,

İrvem²,

Çomoğlu³

et al. 2018

mjima

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Dear Editor,Brucella species can cause a zoonotic infection brucellosis which may affect multiple tissues in the body including musculoskeletal system. Vertebral brucellosis is relatively common in the patients who have musculoskeletal involvement and should be diagnosed rapidly in the endemic regions. Early diagnosis and appropriate antimicrobial therapy combined with surgery are associated with an excellent prognosis; otherwise, delay in diagnosis increases the rate of morbidity and mortality [1] . Isolation of the microorganism from the tissue sample establishes the definite diagnosis and this is also necessary for the differential diagnosis. In this paper we aim to report a patient who presented to our clinic with spondylodiscitis and epidural abscess due to brucellosis.A 46-year-old female patient admitted to our setting with fever for 4 months, chills, and sweating which was exaggerated at night. She also had complaints of lower back pain lasting 2.5 months in addition to fatigue, lack of appetite, and weight loss. She had history of stockbreeding and ate unpasteurized dairy products. On physical examination, her body temperature was 37.5 °C, pain with local pressure was detected on the lumbar vertebrae, and her motor deficit grade was 2/5. The rest of general and neurological examinations were normal. The patient's laboratory test results were as follows: white blood cell count: 4590/mm 3 ; hemoglobin: 9.6 g/dL; hematocrit: 29.2%; erythrocyte sedimentation rate: 95 mm/h; C-reactive protein: 5.9 mg/L (normal, 0 to 0.8 mg/L); and a normal other blood biochemistry profile. The total serum protein, albumin, and globulin were also normal. There was no reversal of the albumin/ globulin ratio, and the Rose Bengal test was positive. The Wright agglutination test for Brucella was also positive at a titer of 1/2560. However, the patient was not tested by the 2-mercaptoethanol. Magnetic resonance imaging (MRI) of the spine was consistent with the diagnosis of spondylodiscitis. The height of the Intervertebral disc between L5-S1vertebrae was decreased in addition to signal abnormality on the vertebral corpus and vertebral endplates in MRI (Figure 1, 2). An epidural abscess, 54x22 mm in size, extending from the posterior of the L5 and S1 vertebrae to the paravertebral space and an abscess, 3x2 cm in size, on the anterior prevertebral space were identified. Upon laminectomy, a purulent epidural and prevertebral mass were evacuated. After decompression, the motor deficit was improved and the pain was relieved. On the Gram stain of the Anahtar Kelimeler: Bakteriyel enfeksiyonlar, Bruselloz, tedavi, epidural apse, dekompresyon cerrahisi

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“…Brucellosis is commonly transmitted by: (1) consumption of unpasteurized or contaminated animal dairy products, (2) direct contact with infected animal parts and (3) inhalation of infected aerosolized particles. Less common means of transmission of the disease include: (1) person to person transmission, (2) blood transfusion, (3) transfusion of harvested bone marrow in recipients of hematopoietic stem cell transplantation (HSCT), and (4) sexual transmission, as in the few reported cases of sexually transmitted brucellosis in humans, the organisms were either cultured from semen or their presence in serum was demonstrated by polymerase chain reaction (PCR) [2,7,[23][24][25]27,32].…”

Section: Risk Factors and Transmission Of Brucellosismentioning

confidence: 99%