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      Brucellosis: An Elusive Backyard Agent

      case-report
      Author(s): 1 , , 1 , 2 , 2
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: brucella, brucellosis, infectious disease, medicine, internal medicine, family medicine, contagious, zoonotic, zoonosis, pasteurization

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          Abstract

          Brucellosis is a form of zoonotic infection caused by various  Brucella organisms. It most commonly presents as a case of pyrexia of unknown origin, alongside symptoms such as night sweats, malaise, arthralgias, and myalgias. This report describes the case of a man who presented with pyrexia of unknown origin for one month; he was diagnosed to be a case of brucellosis after enteric fever was ruled out. Investigations were ordered as it was a differential diagnosis with high clinical suspicion due to the presenting complaint and potential exposure of tainted consumable products. The systemic disease was determined to be brucellosis following blood results demonstrating positive antibody titers, and the suspicion of exposure due to widespread inadequacies in sterilization of food products.

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          A literature review of laboratory-acquired brucellosis.

          Mary Bosserman, Carlos Guerra, Rita Traxler … (2013)
          Brucellosis is a bacterial zoonotic disease which has been associated with laboratory-acquired infections. No recent reviews have addressed the characteristics of laboratory-acquired brucellosis (LAB). English-language literature was reviewed to identify reports of laboratory exposures to Brucella spp. and LAB cases between 1982 and 2007. Evaluation of 28 case reports identified 167 potentially exposed laboratory workers, of whom 71 had LAB. Nine reports were identified that summarized an additional 186 cases of LAB. Only 18 (11%) exposures were due to laboratory accidents, 147 (88%) exposures were due to aerosolization of organisms during routine identification activities, and the circumstances of 2 (1%) exposures were unknown. Brucella melitensis was the causative agent in 80% (135/167) of the exposures. Workers with high-risk exposures were 9.3 times more likely to develop LAB than workers with low-risk exposures (95% confidence interval [CI], 3.0 to 38.6; P < 0.0001); they were also 0.009 times likelier to develop LAB if they took antimicrobial PEP than if they did not (95% CI, 0 to 0.042; P < 0.0001). The median incubation period in case and summary reports was 8 weeks (range 1 to 40 weeks). Antimicrobial PEP is effective in preventing LAB. The incubation period may be used to identify appropriate serological and symptom surveillance time frames for exposed laboratory workers.
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            Treatment of brucellosis: a systematic review of studies in recent twenty years.

            Seyed Alavi, Leila Alavi (2013)
            The treatment of human brucellosis is controversial. The purpose of this study was to search published clinical trial papers to provide a simple and effective treatment in brucellosis.
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              Natural history of brucellosis in an endemic region in different time periods.

              Mile Bosilkovski, Krsto Grozdanovski, Marija Dimzova (2009)
              The aim of the study was to determine the evolution and outcome of human brucellosis in an endemic region in relation to time interval. Retrospective analysis was employed to compare demographic, epidemiological, clinical, laboratory features and the outcome of patients with brucellosis, treated at University Department of Infectious Diseases in Skopje during two different periods of time. A series of 159 patients were studied in the first (1990-1991) and 138 in the second (2003-2005) study period. Patients treated in the second period were older (34.6+/-20.9 vs. 30.0+/-17.7 years; P=0.041) and acquired brucellosis less frequently on ingestion of incriminated food (34.8% vs. 47.2%; P=0.031). Focal forms were more evident in the second period (66.7% vs. 50.3%; P=0.004), mainly due to osteoarticular localization. Post-treatment follow up was more efficient in the second group (76.1% vs. 61%; P=0.005). There was no difference according to disease outcome in spite of different therapeutic trials during the two study periods. In conclusion, the established differences showed an improvement in the understanding of the disease by the general population as well as upgrading of some aspects considering medical activities. Nevertheless, this endemic region still lacks the most important measure, i.e. development and implementation of an appropriate national program for efficient control of the disease.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 16 May 2020
                Publication date (Electronic, collection): May 2020
                Volume: 12
                Issue: 5
                Electronic Location Identifier: e8154
                Affiliations
                [1 ] Internal Medicine, Shifa International Hospital, Islamabad, PAK
                [2 ] Medicine, Shifa International Hospital, Islamabad, PAK
                Author notes
                Article
                DOI: 10.7759/cureus.8154
                PMC ID: 7295138
                PubMed ID: 32550072
                SO-VID: 15aae6e4-732c-430b-b9f6-8165a0d5f9af
                Copyright © Copyright © 2020, Rizvi et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 5 May 2020
                Date accepted : 16 May 2020
                Categories
                Subject: Family/General Practice
                Subject: Internal Medicine
                Subject: Infectious Disease

                Keywords: brucella,brucellosis,infectious disease,medicine,internal medicine,family medicine,contagious,zoonotic,zoonosis,pasteurization
                Data availability:
                Keywords: brucella, brucellosis, infectious disease, medicine, internal medicine, family medicine, contagious, zoonotic, zoonosis, pasteurization

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