Congenital brucellosis: A case report.

Although rare, brucellosis is endemic in the Kingdom of Saudi Arabia (KSA). In the case presented here, a neonate was born at 29 weeks gestation with severe respiratory depression, pyrexia; hypotension and an elevated white blood cell count. Her mother was a 19-year-old pregnant woman who developed premature rupture of the membranes and went into labour early. Sepsis was suspected and so the neonate received dobutamine and empiric ampicillin/gentamicin. The mother reported visiting a farm during her pregnancy and so congenital brucellosis was considered a possibility. Blood cultures were positive for Gram-negative coccobacilli and serology confirmed the presence of Brucella abortus and B. meltiness. Antibiotic treatment was changed to rifampin/gentamicin/ciprofloxacin but on day 17 the baby deteriorated and gentamicin was discontinued and meropenem was added. The neonate gradually improved; meropenem was discontinued on day 24 and the baby was discharged from hospital on day 38.

Congenital brucellosis in a Chinese preterm neonate: A case report.

Although extremely rare, congenital brucellosis can occur via perinatal transmission. We report a case of an infant born prematurely at 34-36 weeks' gestation who had pyrexia, shortness of breath, hepatosplenomegaly and thrombocytopenia. Blood cultures were positive for Gram-negative coccobacilli and Brucella infection was suspected. While, serological tests were negative for Brucella antibodies, B. melitensis infection was confirmed by polymerase chain reaction (PCR). Serology of the parents' blood confirmed the presence of Brucella. The family did not live in an endemic area but had ridden a camel 12 months before the pregnancy. The bacteria may have been sexually transmitted from father to mother and then to foetus via an intrauterine infection. In endemic areas or where the family has been in close contact with infected animals, brucellosis should be suspected in a severely ill neonate with an unknown infection. Thorough medical histories from the family are essential as early diagnosis and prompt therapy will almost certainly improve neonatal outcome.

Congenital Brucellosis: A Systematic Review of the Literature.

BACKGROUND: Knowledge of the spectrum of presentations and the outcome of congenital brucellosis should expedite diagnosis and improve prognostication. METHODS: A systematic review of literature of cases of congenital brucellosis was performed on October 10, 2017 (registered as PROSPERO CRD42017072061). RESULTS: A case seen by the authors was added to the review, yielding 44 reported cases of which 22 (50%) were from Turkey, Saudi Arabia, or Kuwait. For cases with the gestational age reported, 23 of 37 (62%) were preterm. The species was Brucella melitensis in 35 cases, Brucella abortus in 3 cases and not documented in 6 cases. The diagnosis was based on a positive blood culture from the first day of life in 20 cases (45%). Presentation was usually typical for a bacteremic infant of that GA, but two infants were asymptomatic at diagnosis. There were two recurrences and seven deaths (six in preterm infants), but the role of Brucella infection in the deaths was not clear. CONCLUSION: Brucellosis remains a concern in endemic countries, adversely affecting pregnancy and very rarely causing neonatal infection. Prematurity appeared to be the prime cause of death in neonates with congenital brucellosis.

Congenital brucellosis: case report.

A 6-hour-old infant was admitted with severe respiratory distress and hepatosplenomegaly. Her mother had arthralgia for 4 weeks in the 7/8th month of pregnancy and the infant was born at 31 weeks. Brucella spp was detected in blood culture and serology in mother and infant, supporting the diagnosis of brucellosis with presumed transplacental transmission.

Maternal and congenital brucellosis in Texas: changing travel patterns and laboratory implications.

Brucellosis is an uncommon disease in the US, but Texas reports approximately a third of cases. We review the investigation of a pair of mother-infant cases that were unique in the demographics, the nature of travel exposure and the resulting brucellosis exposure in a hospital's delivery suite and laboratory. These cases illustrate the changing nature of travel and the need to obtain a relevant travel history and adequate laboratory procedures. Clinicians and laboratory workers in Texas need to understand that brucellosis remains an endemic disease, but that its epidemiology is changing.

Fiebre y dolor de espalda en un varón joven / Fever and back pain in young male

La brucelosis es una zoonosis de distribución mundial (zona mediterránea, Oriente Próximo, Península de Arabia, India y Latinoamérica), con importantes repercusiones en la salud de los seres humanos y en la cría de animales. En la mayoría de los países, incluido España, es una enfermedad de notificación obligatoria. Se trasmite por contacto directo con la sangre, secreciones uterinas o consumo de productos de origen animal infectados. La brucelosis humana está producida por Brucella melitensis. En España es una enfermedad endémica y aunque las tasas de enfermedad han disminuido en las últimas décadas, la presencia de un cuadro clínico sugerente, junto al antecedente epidemiológico de exposición al microorganismo, deben hacer sospechar la enfermedad. El diagnóstico definitivo requiere el aislamiento de Brucella, generalmente en hemocultivos, aunque actualmente se prefieren las pruebas serológicas (rosa de Bengala, prueba de Coombs, etc.). Debido a la ubicación intracelular del microorganismo no existe ningún antibiótico que por sí solo pueda erradicarlo, por ello y para evitar las recaídas, se utilizan combinaciones de fármacos con efecto sinérgico durante varias semanas. La prevención de la enfermedad en el hombre depende fundamentalmente de la erradicación de la brucelosis animal mediante la vacunación sistemática, y la detección y eliminación de animales infectados (AU)

(Mediterranean area, Middle East, Arabian Peninsula, India and Latin American) with important repercussions on the health of humans and breeding of animals. In most countries, including Spain, it must be reported. It is transmitted by direct contact with the blood, uterine secretions or consumption of infected animal originated products. Human brucellosis is produced Brucella melitensis. In Spain, it is an endemic disease and even though the disease rates have decreased in recent decades, the presence of a suggestive clinical picture together with epidemiological background of exposure to the microorganism show shold lead to suspicion of the disease. The final diagnosis requires isolating Brucella, generally in blood cultures, although currently serological tests are preferred (Bengala Rose, Coombs Test, etc.). Due to the intracellular location of the microorganism, there is no antibiotic that can eradicate it by itself. Thus, and to avoid relapses, combinations of drugs with synergic effect are used for several weeks. Prevention of the disease in man depends fundamentally on the eradication of the animal brucellosis by systematic vaccination and the detection and elimination of infected animals (AU)

Congenital brucellosis: a rare cause of respiratory distress in neonates.

Brucellosis represents a rare cause of neonatal infection. In this article we report a very unusual case of congenital infection due to BRUCELLA MELITENSIS in a term neonate presenting after birth with severe respiratory distress and radiological manifestations (lobar consolidation and diffuse interstitial infiltrations) compatible with pulmonary involvement. The neonate was successfully treated with trimethoprim-sulfamethoxazole, rifampicin, and gentamicin.

The many faces of human-to-human transmission of brucellosis: congenital infection and outbreak of nosocomial disease related to an unrecognized clinical case.

BACKGROUND: Because person-to-person transmission of brucellosis is exceptional, physicians who care for patients with this disease are not considered to be at increased risk. A woman in her 24th week of pregnancy who had received a diagnosis of placenta previa presented to the hospital with massive vaginal bleeding and hypovolemic shock, requiring performance of an emergency Cesarean delivery. Two physicians who assisted the surgical delivery developed culture-proven Brucella melitensis infection. The organism was also recovered from cultures of blood samples obtained from the mother and the premature newborn. The mother had been observed since early pregnancy because of an undiagnosed febrile hepatitis, but no specific tests for brucellosis had been performed. Retrospective testing of serum samples obtained at the onset of disease were positive for Brucella antibodies, indicating that the disease could have been diagnosed earlier. METHODS: Hospital records of the obstetric, intensive care, and surgical departments were examined to identify all staff members who took care of the mother and her offspring. The identified personnel were interrogated about exposure to potentially infective blood and fomites and were screened by blood cultures and serologic tests for Brucella species. RESULTS: An additional physician who assisted in the resuscitation of the newborn had a blood culture positive for B. melitensis and a positive result of a diagnostic serological test. Ninety-five other members of the hospital staff, who were potentially exposed to the organism, were found to be uninfected. CONCLUSIONS: Although rare, transmission of B. melitensis from patients to medical personnel may occur. Strict adherence to universal precautions, especially during performance of medical procedures characterized by massive blood exposure, should be reinforced.

Brucellosis with pulmonary involvement in a premature infant.

Congenital brucellosis is rare. A premature infant with transplacentally acquired congenital brucellosis and pulmonary involvement is described.

Congenital brucellosis in a preterm neonate.

Brucellosis is primarily a zoonotic infection. Transmission to humans occurs through direct contact with infected animals or consumption of infected animal products. Human to human transmission is rare, but has been reported in association with blood transfusion, bone marrow transplantation, transplacental or perinatal exposure, during sexual intercourse and postnatally through breast milk. This report presents a case of transplacentally transmitted neonatal brucellosis.

Neonatal brucellosis.

Three Arab children with neonatal brucellosis are described. The first presented with late neonatal hyperbilirubinaemia, the second with a septicoemia-like picture and the third was born prematurely and presented with respiratory distress. The diagnosis of brucellosis was based on a positive blood culture and on a high or rising titre of antibodies to the Brucella organism. All the three neonates responded well to antibiotic therapy as monitored by a Brucella titre of less than 1:40 and a negative blood culture 10 weeks after the onset of therapy. The three mothers had Brucella infections during pregnancy and the Brucella agglutination titre of the breast milk was high. No Brucella microorganism was isolated from the breast milk. The mode of transmission of brucellosis in neonates is discussed.