"Typhoidal Cells" Appear in a Woman with Hemophagocytic Syndrome Secondary To Brucellosis: A Case Report / 中国医学科学杂志(英文版)

We report a case of hemophagocytic syndrome (HPS) secondary to brucellosis, in which typhoidal cells were found in bone marrow, suggesting typhoidal cells present not only in Salmonella typhi infections but also in other bacterial infections. Typhoidal cells in bone marrow can be used to quickly identify the presence of bacterial infection pending the results of bone marrow and/or blood cultures.

Risk factors for leptospirosis and brucellosis in people living with human immunodeficiency virus who attended a referral hospital in southeastern Brazil

Abstract INTRODUCTION: Leptospirosis and brucellosis cause immunosuppression that worsens the clinical condition of people living with HIV/AIDS (PLWHA). We investigated the serological profile and risk factors of PLWHA. METHODS: Serum samples (n=238) were researched for Brucella spp. antibodies using Rose Bengal and tube agglutination tests and Leptospira spp. antibodies using the microscopic agglutination test. RESULTS: All samples were negative for Brucella spp. For leptospirosis, four samples (1.69%) were positive, and Andamana was the prevalent serovar. CONCLUSIONS: Low or no detection of these zoonoses does not reduce their importance in PLWHA. Vigilant, educational, and preventive measures should be adopted.

Cervical brucellar spondylitis causing incomplete limb paralysis

Abstract Brucellosis, a zoonosis with worldwide distribution, is a systemic infection caused by bacteria of the genus Brucella. Meanwhile, brucellosis often causes complications, such as osteoarticular involvement, and spondylitis is the most prevalent and important clinical form. Here, is a case of cervical brucellar spondylitis causing incomplete limb paralysis in a middle-aged male. The diagnosis was based on clinical history, and supported by Brucella serology and magnetic resonance imaging. Quadruple antibacterial treatment continued for four weeks. In this case, the epidural abscess causing spinal cord compression resolved without surgery. In addition, the patient had recovered from most of the neurologic deficits.

Treatment of a subdural empyema complicated by intracerebral abscess due to Brucella infection

A 55-year-old male presented with fever, stupor, aphasia, and left hemiparesis. A history of head trauma 3 months before was also reported. Cranial magnetic resonance imaging revealed slight contrast enhancement of lesions under the right frontal skull plate and right frontal lobe. Because of deterioration in nutritional status and intracranial hypertension, the patient was prepared for burr hole surgery. A subdural empyema (SDE) recurred after simple drainage. After detection of Brucella species in SDE, craniotomy combined with antibiotic treatment was undertaken. The patient received antibiotic therapy for 6 months (two doses of 2 g ceftriaxone, two doses of 100 mg doxycycline, and 700 mg rifapentine for 6 months) that resulted in complete cure of the infection. Thus, it was speculated that the preexisting subdural hematoma was formed after head trauma, which was followed by a hematogenous infection caused by Brucella species.

The influence of canine brucellosis on morphofunctional features of epididymal spermatozoa: case report / Influência da brucelose canina nos aspectos morfofuncionais de espermatozoides epididimários: relato de caso

The present work reports a clinical case of a mongrel dog, with serological diagnosis of brucellosis, from which epididymal sperm analysis was performed. Sperm samples were collected from different segments of the epididymis (tail, corpus, and caput). Sperm samples were evaluated for computer-assisted motility analysis (CASA), spermatic morphology, mitochondrial activity and sperm plasmatic membrane and acrosomal integrity. Changes in sperm movement patterns were found (progressive motility, percentage of rapid sperm, percentage of rapid velocity, average pathway, curvilinear velocity, velocity straight line, amplitude of lateral head displacement, straightness and linearity), increase of total morphological defects (51%) and absence of sperm mitochondrial activity (20%) were verified, especially for cauda epididymides. We highlight that such changes can contribute to clinical diagnosis of Brucellosis in dogs and to the use of epididymal sperm in reproductive biotechnologies.(AU)

Relata-se o caso de um cão mestiço, com diagnóstico sorológico para brucelose canina, a partir do qual foram realizadas análises do sêmen epididimário. As amostras espermáticas foram coletadas dos diferentes segmentos epididimários (cabeça, corpo e cauda). Foram realizadas as avaliações de motilidade computadorizada do sêmen (CASA), morfologia espermática, atividade mitocondrial, integridade das membranas plasmática e acrossomal. Houve alteração no padrão de movimentação espermática (motilidade progressiva, espermatozoides rápidos, velocidade média da trajetória, velocidade curvilínea, velocidade linear progressiva, amplitude de deslocamento lateral da cabeça, retilinearidade e linearidade), aumento do total de defeitos morfológicos (51%) e da ausência de atividade mitocondrial espermática (20%) dos espermatozoides, especialmente da cauda do epidídimo. Ressalta-se que tais achados podem contribuir para o diagnóstico clínico da brucelose canina e para a utilização do sêmen epididimário em biotecnologias da reprodução.(AU)

Neurobrucellosis and venous sinus thrombosis: an uncommon association

Abstract: Brucellosis is a commonly diagnosed zoonosis and neurological involvement is rare. A 30-year-old woman presented with a pulsatile headache that was exacerbated by the Valsalva maneuver and refractory to analgesic therapy. The patient also had nausea, cough, and coryza that evolved over 7 days. The neurological examination was unremarkable. Thrombosis of the lateral and sigmoid sinus and ipsilateral internal jugular vein were diagnosed and anticoagulation therapy was started. Brucella spp was identified in a sample of cerebrospinal fluid (CSF); five months after treatment with rifampicin and doxycycline, CSF was sterile. Cerebral venous thrombosis is a very uncommon sign of brucellosis.

A rare cause of Rhabdomyolysis from Brucella: a case report / Una causa rara de Rabdomiolisis a partir de Brucella: un reporte de caso

Rhabdomyolysis is caused by myocyte necrosis, which results in the release of muscular cell contents into the circulation and extracellular fluid. We present a case of rhabdomyolysis due to brucella infection without any complications. Following the treatment for brucella, creatinine kinase level was significantly reduced. Rhabdomyolysis associated with brucella is rare in children.

La rabdomiolisis es causada por necrosis del miocito, que resulta de la liberación de los contenidos de la célula muscular en la circulación y el líquido extracelular. Presentamos un caso de rabdomiolisis debido a infección por brucella sin complicaciones. Tras el tratamiento aplicado por brucella, se redujo significativamente el nivel de creatinina kinasa. La rabdomiólisis asociada a brucella es rara en niños.

Anesthetic and hemodynamic management of a rare case of Brucella multivalvular endocarditis in cardiogenic shock undergoing emergency aortic valve replacement and mitral valve repair.

We describe a very rare case of human brucella multivalvular endocarditis. Patient presented in a state of cardiogenic shock with low urine output and a history of breathlessness. Patient was diagnosed to have brucellosis 2 months back by blood cultures and agglutination tests and was receiving doxycycline and rifampicin therapy. Echocardiography showed severe aortic regurgitation, moderate mitral regurgitation, severe left ventricular dysfunction and a mobile vegetation attached to the aortic valve. Patient was scheduled for emergency surgery; while preparing for surgery hemodynamic monitoring, non‑invasive ventilation and inotropic supports were started. During surgery, the aortic valve was found perforated and the aortomitral continuity was disrupted. Aortic valve replacement and mitral valve repair were performed. Hemofiltration was used during cardiopulmonary bypass. Weaning from bypass was achieved with the help of inodilators, dual chamber pacing and intra‑aortic balloon pump.

Respuesta humoral y consecuencias reproductivas en ovejas desafiadas con Brucella ovis al final de la gestación / Immune response and reproductive consequences in experimentally infected ewes with Brucella ovis during late pregnancy

La brucelosis ovina por Brucella ovis es una enfermedad de prevalencia alta en Argentina. Para evaluar la patogenicidad de B. ovis y la respuesta serológica durante el último mes de gestación, 6 ovejas se distribuyeron en dos grupos: G1, ovejas preñadas, n = 4 y G2, ovejas no preñadas, n = 2. Tres ovejas del G1 (15 días preparto) y una del G2 fueron inoculadas con B. ovis. Se analizaron muestras de suero mediante diferentes pruebas serológicas. Se realizó aislamiento y PCR a partir de mucus cérvico-vaginal (mcv), placenta y leche. En las muestras de placenta se realizó histopatología. Las hembras del G1 parieron corderos vivos; se detectaron anticuerpos en las ovejas desafiadas del G1 a partir de los 5 días posinoculación. El mcv de las ovejas desafiadas resultó negativo al aislamiento en ambos grupos. Las muestras de leche del G1 fueron positivas por cultivo y PCR a B. ovis. La técnica de PCR resultó positiva en las placentas de las ovejas desafiadas del G1. La histopatología reveló una placentitis necrótica supurativa en una de las ovejas desafiadas. El desafío con B. ovis preparto resultó en la invasión de la placenta y de la glándula mamaria, con la consecuente excreción de la bacteria por leche. La infección con B. ovis indujo una respuesta humoral temprana en las ovejas. La colonización de la placenta por B. ovis y la excreción de la bacteria por la leche sugieren un potencial riesgo de infección activa para los corderos y la posibilidad de que estos se comporten como portadores latentes de la infección.

Ovine brucellosis by Brucella ovis is a highly prevalent disease in Argentina. This study aimed to evaluate the pathogenicity of B. ovis and the serological response in ewes during late pregnancy and in their offspring. Six adult ewes were distributed in two groupsGI (pregnant females, n = 4) and G2 (nonpregnant females, n = 2). Three pregnant ewes at 15 days prepartum and one nonpregnant eve were inoculated with B. ovis. Sera of sheep and their offspring were analyzed by different serological tests. Samples of cervicovaginal mucus, placenta and milk were studied by bacteriology. A Brucella genus-specific PCR assay was carried out in placenta and milk samples. Placenta samples were hystopathologically processed. G1 females gave birth to live lambs, but one died hours postpartum. Serological techniques employed detected antibodies in serum of inoculated pregnant animal 5 days postchallenge. Sera of female controls G1 and G2 remained negative throughout the study. Cervicovaginal mucus of infected ewes in G1 and G2 yielded negative results to bacteriology, but B. ovis was isolated from milk. The PCR assay was positive for the placenta and milk from inoculated pregnant ewes. Histopathology revealed necrotic suppurative placentitis in one placenta. However, although results demonstrated that B. ovis can invade the placenta and mammary gland, this bacterium did not cause abortion when it was inoculated intravenously at 15 days prepartum. B. ovis infection induced an early humoral response in pregnant ewes, but their lambs remained seronegative, indicating that there was no transfer of antibodies in infancy. Placenta colonization and milk excretion of B. ovis involves a potential source of infection for lambs, which could play a role as latent carriers of infection.

Deep vein thrombosis associated with acute brucellosis: a case report and review of the literature

No abstract available.

Ophthalmoparesis, papillitis and premacular hemorrhage in a case with endocarditis: A rare presentation of brucellosis.

We report a rare presentation of brucellosis as bilateral optic nerve and right abducent nerve involvement, and endocarditis complicated by right premacular hemorrhage in a 28-year-old white female. The patient showed improvement with both medical and surgical therapy. Brucellosis should be considered in the differential diagnosis of papillitis, gaze palsy and endocarditis complicated with premacular hemorrhage in endemic regions.

Epidemiological and clinical features of Brucella arthritis in 24 children

Brucellosis is considered the leading zoonotic disease of the Middle East. The disease has a wide spectrum of clinical manifestations and can result in complications with severe morbidity. The aim of this study was to evaluate the frequency, distribution and characteristics of arthritis in Iranian children with brucellosis. A retrospective descriptive study conducted in a referral children center in Tehran from 1997 to 2005. Arthritis in children with brucellosis who were admitted to a specialized hospital was detected by clinical signs of the involved joint [s] and characteristics of joint fluid aspiration. Socio-demographic information was recorded. Of 96 patients diagnosed with brucellosis, 24 [25%] had Brucella arthritis 14 [58.3%] males and 10 [41.7%] females. Most common manifestations were fever in 21 patients [87.5%] and fatigue in 18 patients [75%]. Monoarthritis was recorded in 15 patients [62.5%] of the cases with involvement of the knee in 8 [45%] and hip in 5 [29%], the ankle in 2 [8%] patients while 9 [37.5%] patients suffered from polyarthritis. None of the patients had axial joints involvement. Seventy-five percent of the subjects [18 patients] were from urban areas and 66.7% [16 patients] had consumed un-pasteurized cheese. Recurrence was not seen in any of the 24 patients who received a combination of co-trimoxazole for 6 weeks and gentamicin for 5 days. Childhood brucellosis is a challenging disease in Iran that has serious complications like arthritis. Therefore all physicians who work in endemic areas should be familiar with this disease and consider the possibility of brucellosis in all children who present with arthritis and arthralgia