The Nature of Human Brucellosis in Kuwait: Study of 379 Cases

Mousa, Alyaa; Elbag, Kamal M.; Kbogali, Mustafa; Marafie, Amin A.

doi:10.1093/clinids/10.1.211

Cited by 107 publications

(54 citation statements)

References 13 publications

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“…Any organs may be affected; humanbrucellosis sometimes develops as thrombophlebitis, peripheral arthritis, carditis, epididymo-orchitis, meningitis and respiratory disorders. Respiratory symptoms such as dry or productive cough and chest pain are reported in up to 20-30% of patients (4,8,10). In the study ofMousaet al, abnormal chest shadows were found in 23 (6.3%) cases out of 379 patients (4).…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Brucellosis in Japan: Difficulties in the Differential Diagnosis from Pulmonary Tuberculosis.

et al. 1996

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Humanbrucellosis is an imported zoonosis extremely uncommonin Japan. Brucellosis was found in a 38-year-old surgeon who had never been abroad; he developed intrapulmonary infiltrates and pleural thickening indistinguishable from pulmonary tuberculosis. Despite extensive antibiotic therapy for tuberculosis he developed systemic serositis. A culture of resected lung tissues grew CO2-required coccobacilli. Polymerase chain reaction test using a specific primer pair for Brucella abortus revealed that the isolated pathogen is highly homologous to B. abortus. We emphasize that undetermined cases of humanbrucellosis maybe present in Japan.

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Section: Discussionmentioning

confidence: 99%

An Unusual Case of Brucellosis in Japan: Difficulties in the Differential Diagnosis from Pulmonary Tuberculosis.

et al. 1996

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“…This is similar to the rates reported in other studies. 10,14 It suggests that the gastrointestinal tract is the likely route of infection in most patients with brucellosis.…”

Section: Discussionmentioning

confidence: 99%

Community-Acquired Bacteremia in a Teaching Hospital in Saudi Arabia

et al. 1989

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During one year, 153 episodes of community-acquired bacteremia were documented at King Khalid University Hospital in Riyadh, with an incidence of 6.7 cases/1000 admissions. Over 70% of the isolates were gram-negative organisms. Brucella sp. accounted for 42% of all isolates. The other common iso lates were Escherichia coli and streptococci. The origin of infection could be identified in 79% of patients with non-Brucella bacteremia, with the urinary and respiratory tracts the most common sources of bacteremia. The mortality of bacteremia in this series was 5.2%. Streptococcus pneumoniae bacteremia was associated with the highest mortality.IOM Al-Orainey, MNS Al-Nasser, ES Saeed, SA Al-Habib, MNH Chowdhury, Community-Acquired Bacteremia in a Teaching Hospital in Saudi Arabia. 1989; 9(6): 547-550 Bacteremia is a serious problem confronting clinicians, as it is associated with a high mortality. Studies done on bacteremia in the West have shown a change in the pattern of the causative organisms, with increasing gramnegative bacteremias, especially in hospital-acquired infections.1-5 The few reports from developing countries showed a different pattern of community-acquired bacteremia, with an increased frequency of pathogens such as Salmonella. [6][7][8] There is very little data on community-acquired bacteremia in Saudi Arabia. This study was therefore undertaken to assess the incidence and pattern of community-acquired bacteremia in a university hospital in Saudi Arabia. Material and MethodsThe study was conducted at King Khalid University Hospital in Riyadh over a period of one year, between 1 November 1986 to 30 October 1987. Patients with community-acquired bacteremia were included. For the purpose of the study, community-acquired bacteremia was defined as an infection present on or before admission to hospital. Bacteremias occurring after admission to the hospital were considered hospital-acquired infections and were excluded from the study.The hospital records of patients with community-acquired bacteremia were reviewed for demographic data, symptoms and signs of infection, results of laboratory tests and cultures, underlying diseases, predisposing factors, therapy, and outcome of each episode of bacteremia. The origin of infection was identified by examining culture results and clinical data. Laboratory MethodsBlood cultures were performed by drawing 10 ml of blood aseptically from each patient and inoculating 5 ml into each of two bottles, one containing tryptic soy broth and the other thiol broth (Difco Laboratories, Detroit,

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“…Diagnosis should ideally be based on demonstrating the organism, but reports from a range of endemic areas draw attention to the relatively low frequency of isolation of the causative organism (Mousa et al, 1988). The BACTEC system increases rates of isolation with shorter times to positivity (Bannatyne et al, 1997) but serological testing has been the mainstay of laboratory diagnosis for many years, with the tube agglutination test and its variants most widely used, and complement fixation, the Coombs test and, more recently, ELISAs used to greater or lesser extents (Young, 2001).…”

Section: Introductionmentioning

confidence: 99%

Large-scale evaluation of a single-tube nested PCR for the laboratory diagnosis of human brucellosis in Kuwait

Al-Nakkas

Mustafa

Wright

2005

Journal of Medical Microbiology

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A single-tube nested PCR assay identifying a 52 bp fragment from the genus-specific Brucella IS711 gene was used prospectively in clinical practice for the diagnosis of human brucellosis in Kuwait. Patients with suspected brucellosis and with other infections were investigated as clinically indicated but in all of them culture, serology and PCR for Brucella were carried out. Out of 263 suspected cases of brucellosis, diagnostic tests were positive in 199, serology was positive in 199 and culture in 89, while the Brucella PCR was positive in 193 (sensitivity 96 . 98 %, 95 % confidence interval 94 . 5-99 . 5 %). Chronic brucellosis, involving symptoms for more than 1 year, was diagnosed in 49 out of these 193 patients. Diagnoses in four out of the six patients with positive serology but negative PCR and culture were non-Brucella bacterial meningitis and viral meningitis. False-negative PCR results were possible in the remaining two; both had been on long-term antibiotics for previously diagnosed brucellosis but their adherence may have been questionable, allowing a relapse. The PCR was negative in 244 patients with other infections (specificity 100 %) and in 180 control subjects with negative Brucella culture and serology. PCR results were available within 24 h of sample receipt, providing diagnostic information rapidly. The PCR is expensive and technically demanding and may not be appropriate for all cases. Future studies will help define how it may best be used. For example Brucella and tuberculous meningitides can be very similar, Brucella PCR may allow prompt distinction between the two, avoiding the need for prolonged empirical treatment for both.

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The Nature of Human Brucellosis in Kuwait: Study of 379 Cases

Cited by 107 publications

References 13 publications

An Unusual Case of Brucellosis in Japan: Difficulties in the Differential Diagnosis from Pulmonary Tuberculosis.

An Unusual Case of Brucellosis in Japan: Difficulties in the Differential Diagnosis from Pulmonary Tuberculosis.

Community-Acquired Bacteremia in a Teaching Hospital in Saudi Arabia

Large-scale evaluation of a single-tube nested PCR for the laboratory diagnosis of human brucellosis in Kuwait

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