Solitary Pulmonary Nodule Due to Brucella Suis

Webb, William A.; Thoroughman, J. C.

doi:10.1378/chest.49.2.222

Cited by 14 publications

(8 citation statements)

References 7 publications

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“…The most frequently affected organs are the liver, bones, endocard and soft tissues (Table 1). Pleuropulmonary manifestations and their histology are described in different case reports [2,4,8,16,[19][20][21][22]. Tuberculosis-like changes are dominant, and men are more often affected ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…Tuberculosis-like changes are dominant, and men are more often affected ( Table 2). Intra-pulmonal nodules with hyalinization and focal calcification are seen as well [4,16,20].…”

Section: Discussionmentioning

confidence: 99%

“…Sacroiliitis developed after ending medication. Serology remained negative at this time (IgG in enzyme-linked immunosorbent assay [ELISA]<5 U/ml, questionable 20-30; IgM ELISA<5 U/ml, questionable [15][16][17][18][19][20]. Antimicrobial treatment was continued.…”

Section: Clinical Historymentioning

confidence: 99%

“…Focal manifestations are found in joints and bones (spondylitis, sacroiliitis, arthritis), the respiratory tract (pneumonia, pleuritis), in the cardiovascular (endocarditis, pericarditis, vasculitis), and nervous system (radiculitis, meningoencephalomyelitis), in the urogenital system (nephritis, epididymitis, orchitis) as well as in the liver, spleen and the skin [3,5,14,25]. Histology of brucellosis shows a granulomatous reaction; additionally, uncharacteristic features are described [1,2,8,11,16,[18][19][20][21][22], which can be seen in a large number of other lung diseases as well [6,12].…”

Section: Introductionmentioning

confidence: 99%

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Brucellosis of the lung: case report and review of the literature

et al. 2007

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Human brucellosis is a worldwide re-emerging zoonosis. However, its histological appearance has only been occasionally described. We report the case of a young girl who had been suffering from a spontaneous fracture of the eighth thoracic vertebra at the age of 7. At the age of 15, X-ray showed a translucence of the seventh and ninth thoracic vertebra, and additionally, a bi-lateral episcleritis was detected. Three months later, she was admitted to the hospital because of perspiration at night and moderate fever. Computer tomography revealed coarsely spotted infiltrates in the lower fields of both lungs. Serology for rheumatic diseases was negative. Thoracoscopical wedge resection was done for histological clarification of pulmonary changes. Microscopically, a granulomatous inflammation with central necrosis was seen. A Ziehl-Neelsen stain did not demonstrate acid-fast bacteria. In spite of negative serology, real-time polymerase chain reaction detected Brucella melitensis deoxyribonucleic acid in the formalin-fixed tissue samples of the lung. Interrogation of the patient revealed visits in different Arabian countries during childhood as a presumable source of infection. In conclusion, granulomatous inflammation negative for Ziehl-Neelsen and Grocott stains presenting together with other localized lesions should lead to specific investigations on brucellosis.

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Section: Discussionmentioning

confidence: 99%

“…Tuberculosis-like changes are dominant, and men are more often affected ( Table 2). Intra-pulmonal nodules with hyalinization and focal calcification are seen as well [4,16,20].…”

Section: Discussionmentioning

confidence: 99%

Section: Clinical Historymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Brucellosis of the lung: case report and review of the literature

et al. 2007

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“…Gram-negative bacteria are rarely implicated in these cases. Brucella suis (11), Bartonella spp. (7), and Burkholderia cepacia (1) have been isolated from pulmonary granulomas, but they are much more commonly isolated from other clinical sources.…”

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confidence: 99%

Isolation and Characterization of “Pseudomonas andersonii” from Four Cases of Pulmonary Granulomas and Emended Species Description

Simmon¹,

Fang²,

Tešić³

et al. 2011

J Clin Microbiol

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"Pseudomonas andersonii" is a Gram-negative bacillus initially isolated from a granulomatous lung lesion. Novel species status has not been validated for this single strain. We report four additional cases of pulmonary granuloma involving P. andersonii and further characterize the organism. These patients had pulmonary nodules that were surgically resected and which grew P. andersonii on routine culture. Mycobacterium avium complex was concomitantly isolated in two cases, and fungal structures were identified histopathologically in two other cases. The five P. andersonii strains described to date were similar in growth characteristics, biochemical reactions, matrix-assisted laser desorption ionization-time of flight mass spectrometry protein profiles, and susceptibility to antimicrobial agents. Their 16S rRNA genes were 99.9 to 100% identical but less than 95.0% similar to those of all other known bacteria. The gyrA genes of these strains were 99.5 to 100% identical. These shared features illustrate P. andersonii as a unique and distinct bacterium and support the novel species status of the organism.Infectious pulmonary granulomas are frequently encountered in pathology practice. They are usually caused by acid-fast bacilli (AFB) or fungi. Gram-negative bacteria are rarely implicated in these cases. Brucella suis (11), Bartonella spp. (7), and Burkholderia cepacia (1) have been isolated from pulmonary granulomas, but they are much more commonly isolated from other clinical sources.In 2001, a novel species, "Pseudomonas andersonii," was implicated as the cause of a pulmonary granuloma (6). Nearly a decade later, this remains the only reported case, and the species name has yet to be validated (4). Based on a single case report, the clinical significance of the novel species is unclear. In this study we report four additional cases of lung granulomas also involving P. andersonii, which was identified by gene sequencing. Characterization of these four P. andersonii strains and the previously described strain suggest that they form a distinct, clinically relevant group of bacteria that differs significantly from other known bacterial species. Case ReportsCase 1. A 57-year-old male from Connecticut with a history of hepatitis C and peripheral vascular disease was found to have a left lung nodule on a chest X-ray during a routine physical examination. He reported a chronic cough but no shortness of breath. He reported frequent travel to Arizona. A computed tomography (CT) scan confirmed a 1.8-cm contrastenhancing solitary nodule in the left lower lobe, with peripheral calcifications. A wedge resection was performed. Histopathology demonstrated a necrotizing granulomatous nodule with Coccidioides spherules by hematoxylin and eosin (H&E), Gomori methenamine silver (GMS), and periodic acid-Schiff (PAS) stains. A Ziehl-Neelsen stain was negative for AFB. A tissue Gram stain did not show definitive bacteria. Cultures were negative for AFB and fungi, but a Gram-negative rod was isolated and later identified as P. andersonii...

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Respiratory Brucellosis

Madkour¹,

Alsaif²

2001

Madkour’s Brucellosis

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Solitary Pulmonary Nodule Due to Brucella Suis

Cited by 14 publications

References 7 publications

Brucellosis of the lung: case report and review of the literature

Brucellosis of the lung: case report and review of the literature

Isolation and Characterization of “Pseudomonas andersonii” from Four Cases of Pulmonary Granulomas and Emended Species Description

Respiratory Brucellosis

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