Septic arthritis caused by Brucella melitensis in urban Shenzhen, China: a case report

Abstract

IntroductionBrucellosis is a systemic infectious disease which is still a challenging medical problem in rural areas such as northern China. It rarely occurs in urban areas such as Shenzhen in southern China. Osteoarticular involvements are frequently seen in brucellosis, and rarely is arthritis the only clinical presentation. We report a case of hip septic arthritis caused by Brucella melitensis in an urban area of Shenzhen, China.Case presentationA 29-year-old Chinese woman, Han ethnical group presented to our hospital with left hip pain persisting for one month. She had a history of contact with goats one month before admission. Her clinical examination showed marked tenderness and limited movement of her left hip. Further imaging showed effusion of her left hip joint. Inflammatory markers including erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) were raised. Our clinical diagnosis was septic arthritis of the left hip. A left hip arthroscopy was performed and the culture was positive for Brucella melitensis. She returned to normal activity after completing a standard antibiotic regimen, including gentamicin at 120mg daily for 2 weeks, doxycycline at 100mg daily and rifampicin at 450mg for a total of 12 weeks.ConclusionsBrucellosis is endemic in some rural areas of China, but rare in urban areas such as Shenzhen in southern China. However, more cases will be expected in urban areas due to increasing migration within China. Physicians should consider brucellosis as one of the differential diagnosis of arthritis. Early surgical intervention is recommended to prevent further joint destruction.

High index of suspicion for brucellosis in a highly cosmopolitan city in southern China

“…Besides the above endemic areas, there is recently an increase in trend of human brucellosis in southern provinces, such as Henan, Guangdong, and Fujian [4]. Retrospective studies in northern China were commonly reported [5,6], yet similar studies were limited in southern China [7,8]. This retrospective study aims to include a case series of brucellosis in Shenzhen, a Southern Chinese cosmopolitan city with over 20 million population including a large immigrant population from other parts of China, and to describe the clinical features and epidemiology of this disease in Shenzhen.…”

Outbreak of Occupational Brucellosis at a Pharmaceutical Factory in Southeast China

“…An outbreak of human brucellosis in Jiangsu province (southern province in China) was due to the plentiful influx of unchecked sheep from the northern part of China and lack of effective prevention programmes (Xiang et al., ). Another brucellosis case reported in Shenzhen was proved to exposure to fed lambs (Wong et al., ). Reported human brucellosis caused by occupational exposure in farm or slaughter house has been documented, and epidemiological features were described in previous studies (Shalmali et al., ; Amira et al., ).…”

Brucella melitensis es un agente de la artritis pediátrica. Serie de casos

“…2 Wong y col. informaron artritis séptica por Brucella en la cadera, mientras que Kalkan y col. informaron esta afección en la rodilla. 12,13 En este estudio, hubo un caso de artritis séptica.…”