1887

Abstract

Introduction:

Brucella 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 Brucella 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.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.005050
2016-09-01
2019-10-18
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/3/5/jmmcr005050.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.005050&mimeType=html&fmt=ahah

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. [CrossRef] [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. [CrossRef]
    [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. [CrossRef] [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. [CrossRef] [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. [CrossRef] [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. [CrossRef] [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. [CrossRef] [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. [CrossRef] [PubMed]
    [Google Scholar]
  10. Franco M. P., Mulder M., Gilman R. H., Smits H. L..( 2007;). Human brucellosis. . Lancet Infect Dis 7: 775–786. [CrossRef] [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. [CrossRef] [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. [CrossRef] [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. [CrossRef] [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. [CrossRef] [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. [CrossRef] [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. [CrossRef] [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. [CrossRef] [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. .336 701.
  21. Solera J., Martínez-Alfaro E., Espinosa A..( 1997;). Recognition and optimum treatment of brucellosis. . Drugs 53: 245–246. [CrossRef] [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. [CrossRef] [PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.005050
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.005050
Loading

Data & Media loading...

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error