Imported brucellosis and Q-fever coinfection in Croatia: a case report

Perić, Ljiljana; Sabadi, Dario; Rubil, Ilija; Bogdan, Maja; Gužvinec, Marija; Rode, Oktavija Đaković; Kaić, Bernard; Tabain, Irena; Vilibić-Čavlek, Tatjana

doi:10.3855/jidc.10151

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…In fact, co-infection of C . burnetii and Brucella species has only been reported once in the literature [ 15 ]. In that case, the patient was a 30-year-old agricultural worker who presented with fever and non-specific symptoms.…”

Section: Discussionmentioning

confidence: 99%

Diverse and atypical manifestations of Q fever in a metropolitan city hospital: Emerging role of next-generation sequencing for laboratory diagnosis of Coxiella burnetii

et al. 2022

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Although Q fever has been widely reported in the rural areas of China, there is a paucity of data on the epidemiology and clinical characteristics of this disease in large metropolitan cities. In this study, we profile the epidemiology and clinical manifestations of Q fever from a tertiary hospital in Shenzhen, a Southern Chinese metropolitan city with a large immigrant population from other parts of China. A total of 14 patients were confirmed to have Q fever during a nine-year-and-six-month period, five of whom were retrospectively diagnosed during case review or incidentally picked up because of another research project on unexplained fever without localizing features. Some patients had the typical exposure histories and clinical features, while a few other patients had rare manifestations of Q fever, including one with heart failure and diffuse intracapillary proliferative glomerulonephritis, a patient presenting with a spontaneous bacterial peritonitis-like syndrome, and another one with concomitant Q fever and brucellosis. Using a combination of clinical manifestation, inflammatory marker levels, echocardiographic findings and serological or molecular test results, nine, three and two patients were diagnosed to have acute, chronic and convalescent Q fever, respectively. Seven, five and two patients were diagnosed to have Q fever by serological test, nested real-time PCR and next-generation sequencing respectively. Diverse and atypical manifestations are associated with Q fever. The incidence of Q fever is likely to be underestimated. Next-generation sequencing is becoming an important diagnostic modality for culture-negative infections, particularly those that the physicians fail to recognize clinically, such as Q fever.

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Section: Discussionmentioning

confidence: 99%

Diverse and atypical manifestations of Q fever in a metropolitan city hospital: Emerging role of next-generation sequencing for laboratory diagnosis of Coxiella burnetii

et al. 2022

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“…As far as we know, this is the first case report in China. In PubMed, we only found one similar case report [ 6 ]. Although it is rare for patients to be infected with Brucella and Rickettsia at the same time, we should not ignore this situation.…”

Section: Discussionmentioning

confidence: 99%

“…Up to now, few cases of mixed infection of Brucella and rickettsia burgdorferi have been reported [ 4 , 5 ]. In PubMed, we found only one similar case report [ 6 ]. Brucellosis and Q fever are probably seriously underestimated and reported as lacking typical clinical symptoms, which are easy to be misdiagnosed and missed.…”

Section: Introductionmentioning

confidence: 99%

Rickettsia burneti and Brucella melitensis co-infection: a case report and literature review

Song

et al. 2021

BMC Microbiol

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Rickettsia is the pathogen of Q fever, Brucella ovis is the pathogen of brucellosis, and both of them are Gram-negative bacteria which are parasitic in cells. The mixed infection of rickettsia and Brucella ovis is rarely reported in clinic. Early diagnosis and treatment are of great significance to the treatment and prognosis of brucellosis and Q fever. Here, we report a case of co-infection Rickettsia burneti and Brucella melitensis. The patient is a 49-year-old sheepherder, who was hospitalized with left forearm trauma. Three days after admission, the patient developed fever of 39.0°C, accompanied by sweating, fatigue, poor appetite and headache. Indirect immunofluorescence (IFA) was used to detect Rickettsia burneti IgM. After 72 hours of blood culture incubation, bacterial growth was detected in aerobic bottles, Gram-negative bacilli were found in culture medium smear, the colony was identified as Brucella melitensis by mass spectrometry. Patients were treated with doxycycline (100 mg bid, po) and rifampicin (600 mg qd, po) for 4 weeks. After treatment, the symptoms disappeared quickly, and there was no sign of recurrence or chronic infection. Q fever and Brucella may exist in high-risk practitioners, so we should routinely detect these two pathogens to prevent missed diagnosis.

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“…We collected a series of case reports associated with Brucella infections and summarized them in (Table 4). 18–27 These reports highlight that Human brucellosis remains the most prevalent zoonotic disease worldwide, affecting numerous countries and a wide range of age groups, including newborns, young adults, and elderly patients. The primary mode of transmission is through the consumption of unpasteurized milk from infected animals.…”

Section: Discussmentioning

confidence: 99%

Brucella infection-induced hemophagocytic syndrome with subsequent development of the probable vanishing bile duct syndrome: A case report and literature review

Xu,

Mo,

2023

SAGE Open Medical Case Reports

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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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Imported brucellosis and Q-fever coinfection in Croatia: a case report

Cited by 9 publications

References 11 publications

Diverse and atypical manifestations of Q fever in a metropolitan city hospital: Emerging role of next-generation sequencing for laboratory diagnosis of Coxiella burnetii

Diverse and atypical manifestations of Q fever in a metropolitan city hospital: Emerging role of next-generation sequencing for laboratory diagnosis of Coxiella burnetii

Rickettsia burneti and Brucella melitensis co-infection: a case report and literature review

Brucella infection-induced hemophagocytic syndrome with subsequent development of the probable vanishing bile duct syndrome: A case report and literature review

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