1887

Abstract

Introduction:

is a zoonotic infection commonly diagnosed by isolation of the organism from blood culture or positive serological testing. It is an uncommon cause of a pyrexia of unknown origin in the United Kingdom.

Case presentation:

We describe the case of a 14-year-old girl with no history of travel who presented with pyrexia, weight loss, arthralgia, multiple splenic abscesses and a subsequent pleural effusion, the latter of which isolated a species on 16S rRNA PCR. The patient responded well to initiation of treatment for brucellosis and on repeat imaging, after 3 months, the splenic abscesses had resolved.

Conclusion:

This unique case demonstrates uncommon complications of brucellosis and the challenges of diagnosing the organism, the latter of which can be alleviated by the utilization of molecularbased technologies. This patient had a negative serology result for brucellosis, which highlights the need to interpret serology results with caution in non-endemic regions for brucellosis.

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2016-09-01
2021-10-27
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References

  1. Ariza J., Pigrau C., Cañas C., Marrón A., Martínez F., Almirante B., Corredoira J. M., Casanova A., Fabregat J., Pahissa A. 2001; Current understanding and management of chronic hepatosplenic suppurative brucellosis. Clin Infect Dis 32:1024–1033 [View Article][PubMed]
    [Google Scholar]
  2. Aygen B., Doğanay M., Sümerkan B., Yildiz O., Kayabaş Ü. 2002; Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 32:485–493 [View Article]
    [Google Scholar]
  3. Azira J. 1996; Brucellosis. Curr. Opin.Infect.Dis 9:126–131 [CrossRef]
    [Google Scholar]
  4. Baykam N., Esener H., Ergönül O., Eren S., Celikbas A. K., Dokuzoguz B. 2004; In vitro antimicrobial susceptibility of Brucella species. Int J Antimicrob Agents 23:405–407 [View Article][PubMed]
    [Google Scholar]
  5. Bosilkovski M., Katerina S., Zaklina S., Ivan V. 2010; The role of Brucellacapt test for follow-up patients with brucellosis. Comp Immunol Microbiol Infect Dis 33: 435 [View Article][PubMed]
    [Google Scholar]
  6. Casao M. A., Navarro E., Solera J. 2004; Evaluation of Brucellacapt for the diagnosis of human brucellosis. J Infect 49:102–108 [View Article][PubMed]
    [Google Scholar]
  7. Christopher S., Umapathy B. L., Ravikumar K. L. 2010; Brucellosis: review on the recent trends in pathogenicity and laboratory diagnosis. J Lab Physicians 2:55–60 [View Article][PubMed]
    [Google Scholar]
  8. Fadeel M. A., Hoffmaster A. R., Shi J., Pimentel G., Stoddard R. A. 2011; Comparison of four commercial IgM and IgG ELISA kits for diagnosing brucellosis. J Med Microbiol 60:1767–1773 [View Article][PubMed]
    [Google Scholar]
  9. Falagas M. E., Bliziotis I. A. 2006; Quinolones for treatment of human brucellosis: critical review of the evidence from microbiological and clinical studies. Antimicrob Agents Chemother 50:22–33 [View Article][PubMed]
    [Google Scholar]
  10. Franco M. P., Mulder M., Gilman R. H., Smits H. L. 2007; Human brucellosis. Lancet Infect Dis 7:775–786 [View Article][PubMed]
    [Google Scholar]
  11. Hasanjani Roushan M. R., Mohrez M., Smailnejad Gangi S. M., Soleimani Amiri M. J., Hajiahmadi M. 2004; Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran. Epidemiol Infect 132:1109–1114 [View Article][PubMed]
    [Google Scholar]
  12. Health Protection Agency 2013 England 30 October 2013 www.hpa.org.uk
  13. Mantur B., Parande A., Amarnath S., Patil G., Walvekar R., Desai A., Parande M., Shinde R., Chandrashekar M., Patil S. 2010; ELISA versus conventional methods of diagnosing endemic brucellosis. Am J Trop Med Hyg 83:314–318 [View Article][PubMed]
    [Google Scholar]
  14. Mantur B. G., Mulimani M. S., Bidari L. H., Akki A. S., Tikare N. V. 2008; Bacteremia is as unpredictable as clinical manifestations in human brucellosis. Int J Infect Dis 12:303–307 [View Article][PubMed]
    [Google Scholar]
  15. Mitka S., Anetakis C., Souliou E., Diza E., Kansouzidou A. 2007; Evaluation of different PCR assays for early detection of acute and relapsing brucellosis in humans in comparison with conventional methods. J Clin Microbiol 45:1211–1218 [View Article][PubMed]
    [Google Scholar]
  16. Orduña A., Almaraz A., Prado A., Gutierrez M. P., Garcia-Pascual A., Dueñas A., Cuervo M., Abad R., Hernández B. et al. 2000; Evaluation of an immunocapture-agglutination test (Brucellacapt) for serodiagnosis of human brucellosis. J Clin Microbiol 38:4000–4005[PubMed]
    [Google Scholar]
  17. Parande A. M., Mantur B. G., Kore M., Palled E. 2010; Splenic abscess due to Brucella melitensis - a rare pediatric complication. J Lab Physicians 2:105–108 [View Article][PubMed]
    [Google Scholar]
  18. Pourbagher M. A., Pourbagher A., Savas L., Turunc T., Demiroglu Y. Z., Erol I., Yalcintas D. 2006; Clinical pattern and abdominal sonographic findings in 251 cases of brucellosis in southern Turkey. AJR Am J Roentgenol 187:W191–W194 [View Article][PubMed]
    [Google Scholar]
  19. Saglani S., Harris K. A., Wallis C., Hartley J. C. 2005; Empyema: the use of broad range 16S rDNA PCR for pathogen detection. Arch Dis Child 90:70–73 [View Article][PubMed]
    [Google Scholar]
  20. Skalsky S., Yahav D., Bishara J., Pitlik S., Leibovici L., Paul M. 2008; Treatment of human brucellosis: systematic review and meta- analysis of randomised controlled trials BMJ . 336701
  21. Solera J., Martínez-Alfaro E., Espinosa A. 1997; Recognition and optimum treatment of brucellosis. Drugs 53:245–246 [View Article][PubMed]
    [Google Scholar]
  22. Vallejo J. G., Stevens A. M., Dutton R. V., Kaplan S. L. 1996; Hepatosplenic abscesses due to Brucella melitensis: report of a case involving a child and review of the literature. Clin Infect Dis 22:485–489 [View Article][PubMed]
    [Google Scholar]
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