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BMC Infectious Diseases May 2024Brucellosis, a zoonotic disease caused by Brucella species, poses a significant global health concern. Among its diverse clinical manifestations, neurobrucellosis... (Review)
Review
Brucellosis, a zoonotic disease caused by Brucella species, poses a significant global health concern. Among its diverse clinical manifestations, neurobrucellosis remains an infrequent yet debilitating complication. Here, we present a rare case of neurobrucellosis with unusual presentations in a 45-year-old woman. The patient's clinical course included progressive lower extremity weakness, muscle wasting, and double vision, prompting a comprehensive diagnostic evaluation. Notable findings included polyneuropathy, elevated brucella agglutination titers in both cerebrospinal fluid and blood, abnormal EMG-NCV tests, and resolving symptoms with antibiotic therapy. The clinical presentation, diagnostic challenges, and differentiation from other neurological conditions are discussed. This case underscores the importance of considering neurobrucellosis in regions where brucellosis is prevalent and highlights this rare neurological complication's distinctive clinical and radiological features. Early recognition and appropriate treatment are crucial to mitigate the significant morbidity associated with neurobrucellosis.
Topics: Humans; Female; Brucellosis; Middle Aged; Polyradiculoneuropathy; Anti-Bacterial Agents; Brucella
PubMed: 38745172
DOI: 10.1186/s12879-024-09365-2 -
BMC Infectious Diseases May 2024It is challenging to diagnose brucellosis in nonendemic regions because it is a nonspecific febrile disease. The accurate identification of Brucella spp. in clinical...
BACKGROUND
It is challenging to diagnose brucellosis in nonendemic regions because it is a nonspecific febrile disease. The accurate identification of Brucella spp. in clinical microbiology laboratories (CMLs) continues to pose difficulties. Most reports of misidentification are for B. melitensis, and we report a rare case of misidentified B. abortus.
CASE PRESENTATION
A 67-year-old man visited an outpatient clinic complaining of fatigue, fever, and weight loss. The patient had a history of slaughtering cows with brucellosis one year prior, and his Brucella antibody tests were negative twice. After blood culture, the administration of doxycycline and rifampin was initiated. The patient was hospitalized due to a positive blood culture. Gram-negative coccobacilli were detected in aerobic blood culture bottles, but the CML's lack of experience with Brucella prevented appropriate further testing. Inaccurate identification results were obtained for a GN ID card of VITEK 2 (bioMérieux, USA) and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) using a MALDI Biotyper (Bruker, Germany). The strain showed 100.0% identity with Brucella spp. according to 16S rRNA sequencing. MALDI-TOF MS peaks were reanalyzed using the CDC MicrobeNet database to determine Brucella spp. (score value: 2.023). The patient was discharged after nine days of hospitalization and improved after maintaining only doxycycline for six weeks. The isolate was also identified as Brucella abortus by genomic evidence.
CONCLUSION
Automated identification instruments and MALDI-TOF MS are widely used to identify bacteria in CMLs, but there are limitations in accurately identifying Brucella spp. It is important for CMLs to be aware of the possibility of brucellosis through communication with clinicians. Performing an analysis with an additional well-curated MALDI-TOF MS database such as Bruker security-relevant (SR) database or CDC MicrobeNet database is helpful for quickly identifying the genus Brucella.
Topics: Aged; Humans; Male; Brucellosis; Brucella abortus; Bacteremia; Delayed Diagnosis; Anti-Bacterial Agents; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Animals
PubMed: 38741035
DOI: 10.1186/s12879-024-09377-y -
BMC Infectious Diseases May 2024Neurobrucellosis (NB) is a rare and serious complication of brucellosis. Its clinical manifestations vary, with no obvious specificity. At present, there is no clear...
BACKGROUND
Neurobrucellosis (NB) is a rare and serious complication of brucellosis. Its clinical manifestations vary, with no obvious specificity. At present, there is no clear clinical diagnosis or treatment for reference. In this study, we retrospectively analyzed the clinical data for 21 patients with NB to provide reference data for its further study.
METHODS
We analyzed the epidemiological and clinical manifestations, laboratory tests, imaging examinations, cerebrospinal fluid, and treatment plans of 21 patients diagnosed with NB in the Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China.
RESULTS
The ages of the patients ranged from 15 to 60 years old (mean age 40.1 ± 13.33 years), the male: female ratio was 4.25:1. Thirteen patients had a history of animal (sheep, cattle) contact, three had no history of animal contact, and the contact status of four was unknown. Brucella can invade various systems of the body and show multi-system symptoms, the main general manifestations were fever (66.67%), fatigue (57.14%) and functional urination or defecation disturbance (42.86%). The main nervous system manifestations were limb weakness (52.38%) and hearing loss (47.62%).The main positive signs of the nervous system included positive pathological signs (71.43%), sensory abnormalities (52.38%), limb paralysis (42.86%). Nervous system lesions mainly included spinal cord damage (66.67%), cranial nerve involvement (61.90%), central demyelination (28.57%) and meningitis (28.57%). In patients with cranial nerve involvement, 69.23% of auditory nerve, 15.38% of optic nerve and 15.38% of oculomotor nerve were involved. The blood of eight patients was cultured for Brucella, and three (37.5%) cultures were positive and five (63.5%) negative. The cerebrospinal fluid (CSF) of eight patients was cultured for Brucella, and two (25.00%) cultures were positive and six (75.00%) negative. Nineteen of the patients underwent a serum agglutination test (SAT), 18 (94.74%) of whom were positive and one (5.26%) of whom were negative. A biochemical analysis of the CSF was performed in 21 patients, and the results were all abnormal. Nineteen patients underwent magnetic resonance imaging (MRI). Twenty-one patients were treated with doxycycline and/or rifampicin, combined with ceftriaxone, quinolone, aminoglycoside, or minocycline. After hospitalization, 15 patients improved (71.43%), two patients did not recover, and the status of four patients was unknown.
CONCLUSIONS
The clinical manifestations, CSF parameters, and neurological imaging data for patients with NB show no significant specificity or correlations. When patients with unexplained neurological symptoms accompanied by fever, fatigue, and other systemic manifestations in a brucellosis epidemic area or with a history of contact with cattle, sheep, animals, or raw food are encountered in clinical practice, the possibility of NB should be considered. Treatment is based on the principles of an early, combined, and long course of treatment, and the general prognosis is good.
Topics: Humans; Male; Female; Middle Aged; Brucellosis; Adult; Anti-Bacterial Agents; Retrospective Studies; Adolescent; Young Adult; China; Treatment Outcome; Brucella; Animals
PubMed: 38730327
DOI: 10.1186/s12879-024-09308-x -
Frontiers in Public Health 2024Human brucellosis is a neglected disease transmitted to humans from animals such as cattle, goats, dogs, and swine. The causative agents are bacteria of the genus ,...
BACKGROUND
Human brucellosis is a neglected disease transmitted to humans from animals such as cattle, goats, dogs, and swine. The causative agents are bacteria of the genus , intracellular pathogens usually confined to the reproductive organs of their animal hosts causing sterility and abortions. The objective of the study was to determine the seroprevalence of brucellosis among women with spontaneous abortions (SAW) and compare this seroprevalence with that of healthy pregnant women (HPW).
METHODS
The case-control study was designed to determine the seroprevalence and molecular detection of brucellosis in women who suffered from spontaneous abortion and healthy pregnant women of the Haripur District of Pakistan. A total of 770 blood samples ( = 385 for each group) were collected from 9 public and 11 private hospitals in Haripur District from December 2021-March 2023. Data on demographic features, epidemiological variables, and risk factors were collected from each participant by structured questionnaires. Initial screening for brucellosis was performed by Rose Bengal Plate Test followed by qRT-PCR for molecular detection of the genus-specific gene of .
RESULTS
The study showed that anti-Brucella antibodies were more found in SAW 23.63% (91/385) than in HPW 1.29% (5/385). specific DNA was amplified in 89.01% (81/91) seropositive samples of SAW. Demographic features and risk factors such as age, urbanicity, socioeconomic status, education, occupation, and animal contact were found significantly associated with brucellosis ( ≤ 0.05). Consumption of unpasteurized raw milk (OR = 18.28, 95%CI: 8.16-40.94) was found highly concomitant with seroprevalence.
CONCLUSION
This study reports the first evidence of involvement of brucellosis in spontaneous abortions in women of Pakistan. The study can be used to develop strategies for risk management during pregnancy, to raise awareness for brucellosis, and develop control programs.
Topics: Humans; Female; Pakistan; Seroepidemiologic Studies; Brucellosis; Adult; Case-Control Studies; Pregnancy; Abortion, Spontaneous; Brucella; Risk Factors; Young Adult; Adolescent; Animals
PubMed: 38689773
DOI: 10.3389/fpubh.2024.1372327 -
Mikrobiyoloji Bulteni Apr 2024Brucellosis is a zoonotic disease endemic in many developing countries, including Türkiye. Among the species that are pathogenic for humans; Brucella melitensis is...
Brucellosis is a zoonotic disease endemic in many developing countries, including Türkiye. Among the species that are pathogenic for humans; Brucella melitensis is isolated from livestock animals like sheep and goats, Brucella abortus from cattle and Brucella suis from pigs. Laboratory diagnosis of infection caused by Brucella species with gram-negative coccobacillus morphology; can be made through characteristic culture features, serological tests and molecular methods. Brucellosis, which has a wide distribution of clinical signs and symptoms; can cause various complications by affecting many organs and systems. Among all complications, the probability of thyroid abscess is less than 1%. In this case report; an example of thyroid abscess, one of the rare complications of brucellosis that is not frequently encountered in the literature, was presented. During the physical examination of a 45-year-old female patient who admitted with the complaint of pain in the neck area, fever, neck swelling, redness and pain that increased with palpation were detected. Leukocytosis, lymphopenia, high sedimentation and CRP, low TSH and high T4 values were detected in laboratory tests and subacute thyroiditis was considered as the preliminary diagnosis. Surgical abscess drainage was planned as the patient's clinical findings progressed during follow-up and spontaneous pus discharged from the midline of the neck. The abscess aspirate sample taken during surgical intervention and the blood culture samples taken before were evaluated microbiologically. Microorganisms that did not grow on EMB agar but grew on 5% sheep blood and chocolate agar at the 72-96th hour of incubation of culture plates; were detected to have gram-negative coccobacillus morphology and positive for catalase, oxidase and urease. Although the Wright test was negative with a titer of 1/20, the Rose Bengal test was positive, Coombs test was positive with a titer of 1/160 and the Brucellacapt test was positive with a titer of >1/5120. Microorganisms growing on culture plates were identified as B.melitensis at the species level with specific antisera. As a result of antibiotic susceptibility tests evaluated according to the European Committee on Antimicrobial Susceptibility Testing version 14.0 (EUCAST v14.0), the isolate was susceptible to rifampicin, doxycycline, gentamicin and trimethoprim-sulfamethoxazole at standart dosing regimen and susceptible to ciprofloxacin and levofloxacin at increased exposure. The patient, who was started on doxycycline and rifampicin combination treatment, was discharged without any complaints. In the diagnosis of infection due to Brucella species, which is one of the pathogens that early diagnosis and initiation of treatment greatly affects the prognosis; in addition to culture, which is the gold standard method, serological tests are also very important. If diagnosis is delayed, complications may develop due to involvement in almost every part of the body, depending on the affected organs and systems. In areas where brucellosis is endemic, patients with symptoms such as neck swelling, shortness of breath and difficulty in swallowing, thyroid tissue involvement due to brucellosis should definitely be considered etiologically.
Topics: Brucella melitensis; Brucellosis; Humans; Female; Abscess; Middle Aged; Anti-Bacterial Agents; Drainage; Thyroiditis, Subacute; Thyroid Diseases
PubMed: 38676588
DOI: 10.5578/mb.20249810 -
Open Veterinary Journal Jan 2024Brucellosis is a highly contagious zoonotic disease caused by an intracellular facultative microorganism termed spp. Control of brucellosis depends on test and...
BACKGROUND
Brucellosis is a highly contagious zoonotic disease caused by an intracellular facultative microorganism termed spp. Control of brucellosis depends on test and slaughter policy as well as vaccination programs.
AIM
Estimation of the cell-mediated immunity (CMI) [total leukocytic count (TLC), phagocytic activity, phagocytic index, interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-α)] in camels after vaccination with RB51 using real-time polymerase chain reaction (PCR).
METHODS
A total of eight camels were grouped into two groups as follows: group (A): vaccinated with RB51 vaccine [1 dose/2 ml S/C (3 × 10 CFU)] and group (B): control group. IL-6 and TNF-α were used for estimation of the CMI using real-time PCR on serum samples that were collected at 0, 7, 14, 21, 28, and 60 days after vaccination from each group. In addition, TLC, phagocytic activity, and phagocytic index were evaluated on heparinized blood samples at 0 and 60 days post-vaccination.
RESULTS
RB51 vaccine provides a protective immune response which progressively increases from the first week to 60 days after vaccination. Moreover, the levels of TNF-α and IL-6 differed between camels in the vaccinated group.
CONCLUSION
Vaccination of camels with RB51 vaccine (with dose 3 × 10 CFU) could induce good protective immune responses and this immunological response will be a good indication for a safe field vaccine that can be used for the control of camel brucellosis.
Topics: Animals; Brucella abortus; Camelus; Interleukin-6; Tumor Necrosis Factor-alpha; Egypt; Brucellosis; Vaccination; Brucella Vaccine
PubMed: 38633148
DOI: 10.5455/OVJ.2024.v14.i1.3 -
International Journal of Systematic and... Apr 2024The alphaproteobacterial order consists of 38 families comprising at least 152 validly published genera as of January 2024. The order was first described in 1957 and...
The alphaproteobacterial order consists of 38 families comprising at least 152 validly published genera as of January 2024. The order was first described in 1957 and underwent important revisions in 2020. However, we show that several inconsistencies in the taxonomy of this order remain and we argue that there is a need for a consistent framework for defining families within the order. We propose a common genome-based framework for defining families within the order , suggesting that families represent monophyletic groups in core-genome phylogenies that share pairwise average amino acid identity values above ~75 % when calculated from a core set of 59 proteins. Applying this framework, we propose the formation of four new families and to reassign the genera , , and into fam. nov., fam. nov., and fam. nov., respectively, and the genera , , , and into fam. nov. We further propose to unify the families , , , and as ; the families and as ; the families and as ; and the families and as . Lastly, we propose to reassign several genera to existing families. Specifically, we propose to reassign the genus to the family ; the genera , , and to the family ; the genus to the emended family ; the genus to the family ; and the genus to the family . Our data also support the recent proposal to reassign the genus to the family .
Topics: Humans; Phylogeny; Sequence Analysis, DNA; Fatty Acids; RNA, Ribosomal, 16S; DNA, Bacterial; Base Composition; Bacterial Typing Techniques; Alphaproteobacteria; Beijerinckiaceae
PubMed: 38619983
DOI: 10.1099/ijsem.0.006328 -
Journal of Clinical Microbiology Apr 2024
Review
Topics: Humans; Brucella abortus; Incidental Findings; Brucellosis; Bacteremia; Urinary Tract Infections
PubMed: 38597631
DOI: 10.1128/jcm.01381-23 -
Veterinary Medicine and Science May 2024Cross-border livestock mobility through transhumance is mainly practiced in West African countries for seasonal access to resources and market. Cross-border herds are...
BACKGROUND
Cross-border livestock mobility through transhumance is mainly practiced in West African countries for seasonal access to resources and market. Cross-border herds are involved in the dynamic of transboundary animal diseases among them brucellosis taken as model. Brucellosis is a zoonotic disease causing abortion.
OBJECTIVES
This study explores the seroprevalence of brucellosis according to mobility and infection spread between Mali and Côte d'Ivoire in the context of seasonal cross-border transhumance.
METHODS
From February to April 2021, a transversal serological survey of brucellosis was conducted on 521 cattle from 111 transhumant herds and 283 cattle from 59 sedentary herds, all from Mali.
RESULTS
The global individual seroprevalence for Brucella spp. in transhumant and sedentary cattle from Mali was 8.2% (95% CI = 6.0-10.5). At herd level, seroprevalence was 21.2% with a significant variation between transhumant (11.7%) and sedentary (39.0%) herds. For herds in transhumance, cattle seropositivity was associated with a previous infection suspected by herdsmen odds ratio (OR = 4.4; 95% CI = 1.1-18.1) and unknown abortion aetiology (OR = 4.3; 95% CI = 1.0-17.3). The departure region (coming from Sikasso) and previous brucellosis infection or unexplained abortion could be used to predict Brucella infection in transhumant herds with a probability of around 60%. The risk of brucellosis introduction in host regions was high despite the individual animal seroprevalence of 3.6% and a low sale rate in transhumant cattle.
CONCLUSIONS
The findings suggest that testing transhumant during border control and survey of cattle markets and sales could improve risk control of the spread of disease at regional scale.
Topics: Pregnancy; Female; Animals; Cattle; Seroepidemiologic Studies; Brucellosis; Zoonoses; Brucella; Risk Factors
PubMed: 38595033
DOI: 10.1002/vms3.1446 -
European Review For Medical and... Mar 2024Non-specific features of spondylodiscitis lead to a delay and challenge in the diagnosis/differential diagnosis/treatment processes, and thus, serious complications may...
OBJECTIVE
Non-specific features of spondylodiscitis lead to a delay and challenge in the diagnosis/differential diagnosis/treatment processes, and thus, serious complications may arise. This study aims to compare brucellar, pyogenic, and tuberculous types of spondylodiscitis, considering their demographic, clinical, and laboratory differences. This may provide more rapid management and good outcomes.
PATIENTS AND METHODS
A total of 131 patients with infectious spondylodiscitis were included in the study. The patients were divided into brucellar (n=63), pyogenic (n=53), and tuberculous (n=15) types of spondylodiscitis and compared for demographic, clinical, laboratory, and imaging features.
RESULTS
Tuberculous spondylodiscitis had higher scores for weight loss, painless palpation, thoracic spine involvement, and psoas abscess formation than other spondylodiscitis. Also, tuberculous spondylodiscitis had higher rates of neurologic deficit and lower rates of lumbar involvement than brucellar spondylodiscitis. Pyogenic spondylodiscitis is more likely to occur in patients who have a history of spine surgery compared to other forms of spondylodiscitis. Also, pyogenic spondylodiscitis had higher rates of fever, erythema, paraspinal abscess, white blood cell (WBC), and erythrocyte sedimentation rate (ESR) than brucellar spondylodiscitis. On the other hand, brucellar spondylodiscitis had higher rates of rural living and sweating than pyogenic spondylodiscitis.
CONCLUSIONS
Weight loss, painless palpation, involved thoracic spine, psoas abscess, and neurologic deficit are symptoms favoring tuberculous spondylodiscitis. History of spine surgery, high fever, skin erythema, and paraspinal abscess are findings in favor of pyogenic spondylodiscitis. Rural living, sweating, and involved lumbar spine are symptoms that indicate brucellar spondylodiscitis. These symptoms can be used to distinguish the types of spondylodiscitis.
Topics: Humans; Discitis; Brucella; Psoas Abscess; Tuberculosis; Lumbar Vertebrae; Erythema; Weight Loss; Retrospective Studies
PubMed: 38567614
DOI: 10.26355/eurrev_202403_35761