DOI: http://dx.doi.org/10.18203/2349-3933.ijam20183150

Human brucellosis in a non-susceptible host: a case report

Yoganathan Chidambaram, Murali Alagesan, Clement Jenil Dhas

Abstract


Clinical human brucellosis is quite rare in India, that too in an non susceptible host. This report describes a case of clinical human brucellosis in India. This case involved a 36 years old male, a professor in an Engineering college. He presented with complaints of fever for 4 months with myalgia, generalized tiredness, loss of weight and loss of appetite. On evaluation, total counts and ESR was elevated and all other investigations were normal. Based on history, common causes like occult tuberculosis or autoimmune diseases were considered. But, blood cultures grew Brucella melitensis in all 2 samples and a diagnosis of brucellosis was made. He was treated with Rifampicin and Doxycycline. Suspicion of brucellosis in this patient is low because the patient has no history of contact with animals, consumption of unpasteurized milk or occupational exposure. So, the health care practitioners should be aware of this possibility of this zoonotic infection as a differential diagnosis in patients with nonspecific symptoms and unexplained prolonged fever.


Keywords


Brucellosis, Non-susceptible host, Prolonged fever

Full Text:

PDF

References


Ramin B, MacPherson P. Human brucellosis. Br Med J. 2013;341:c4545.

Cohen J, Powderly WG, Opal SM, Calandra T, Clumeck N, et al. Infectious diseases. 3rd ed. China: Mosby. 2010.

Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol. 2007;25(3):188-202.

Gwida M, Al Dahouk S, Melzer F, Rösler U, Neubauer H, Tomaso H. Brucellosis–regionally emerging zoonotic disease?. Croatian Med J. 2010;51(4):289-95.

Akhtar R, Chaudhry ZI, Shakoori AR, Ahmad M, Aslam A. Comparative efficacy of conventional diagnostic methods and evaluation of polymerase chain reaction for the diagnosis of bovine brucellosis. Vet World. 2010;3(2):53-6.

Zhang Z, Yu S, Wang X, Dong S, Xu J, Wang J, et al. Human brucellosis in the People’s Republic of China during 2005-2010. Int J Infect Dis. 2013;17(5):e289-e292.

Priyantha MA. Identification of biovars of Brucella abortus in aborted cattle and buffaloes herd in Sri Lanka. Vet World. 2011;4:542-5.

Franco MP, Mulder M, Gilman RH, Smits HL, 2007. Human brucellosis. Lancet Infect Dis 7: 775-86.

Seleem MN, Boyle SM, Sriranganathan N. Brucellosis: a re-emerging zoonosis. Veterinary Microbiol. 2010;140(3-4):392-8.

Dean AS, Crump L, Greter H, Hattendorf J, Schelling E, Zinsstag J. Clinical manifestations of human brucellosis: a systematic review and meta-analysis. PLoS neglected tropical diseases. 2012;6(12):e1929.

Rolando I, Olarte L, Vilchez G, Lluncor M, Otero L, Paris M, Carrillo C, Gotuzzo E. Ocular manifestations associated with brucellosis: a 26-year experience in Peru. Clin Infect Dis. 2008;46(9):1338-45.

Sari I, Altuntas F, Hacioglu S, Kocyigit I, Sevinc A, Sacar S, et al. A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis. Am J Hematol. 2008;83(4):334-9.

Gilbert DN, Chambers HF, Eliopolus GM, Saag MS, Pavia AT, et al. Guide to antimicrobial therapy 2016. 46th ed. USA: Antimicrobial Therapy Inc; 2016.

Lubani MM, Dudin KI, Sharda DC, Ndhar DS, Araj GF, Hafez HA et al. A multicenter therapeutic study of 1100 children with brucellosis. Pediatr Infectious Dis J. 1989;8(2):75-8.

Solera J, Martinez-Alfaro E, Espinosa A. Recognition and optimum treatment of brucellosis. Drugs. 1997;53(2):245-56.