Nontuberculous Mycobacterium infection complicated with Haemophagocytic syndrome: a case report and literature review
What Is Brucellosis?
Brucellosis is an infectious disease caused by a type of bacteria called Brucella. The bacteria can spread from animals to humans.
There are several different strains of Brucella bacteria. Some types are seen in cows. Others occur in dogs, pigs, sheep, goats, and camels. Recently, scientists have seen new strains in the red fox and certain marine animals, including seals. Brucella in animals cannot be cured.
Brucellosis is rare in the U.S. Because of effective animal disease control programs. Fewer than 200 people get sick with the disease each year in the U.S. It is most often seen in the spring and summer months in:
Brucellosis is considered a significant health threat in other parts of the world. The disease has been reported in more than a half-million people each year in 100 countries, according to the World Health Organization.
Brucellosis in humans occurs when a person comes into contact with an animal or animal product infected with the Brucella bacteria.
Very rarely, the bacteria may spread from person to person. Breastfeeding moms with brucellosis may pass the bacteria to their baby. Brucella may also be spread through sexual contact.
The bacteria can enter your body:
Four types of Brucella bacteria cause the majority of brucellosis infections in humans:
B. Melitensis. This type causes most cases of human brucellosis and is mainly found in sheep and goats. It is most often seen in:
B. Suis. This infection found in wild pigs is the most common type of Brucella seen in the U.S. Brucellosis due to this strain most often occurs in the Southeast and California. It also occurs in Europe, South America, and Southeast Asia.
B. Canis. The infection from this type of bacteria spreads from dogs. It is most often seen in:
B. Abortus. This infection comes from cattle. It occurs worldwide. It has been wiped out in several European countries, Japan, Israel, Canada, Australia, and New Zealand.
Dogs can become infected with B. Canis. Some pet owners have developed brucellosis this way but the disease is usually mild. There is at least one known case of brucellosis spreading to a human by a dog bite. But spreading brucellosis this way is uncommon. Most dogs infected with Brucella do NOT spread the bacteria to their owners.
You are more likely to get brucellosis from an infected dog if you come in contact with blood or other fluids from the animal. Veterinarians have an increased risk of brucellosis.
If you have a weakened immune system due to medications or certain diseases, you should not touch dogs that are infected with Brucella.
In the U.S., brucellosis is more common in men. Men who become sick with the disease most often work or have worked around livestock. Brucellosis is uncommon in children.
You are more likely to get brucellosis if you:
Brucellosis has also been reported in:
General symptoms of brucellosis are often vague and similar to the flu. They may include:
Symptoms usually appear within five to 30 days after you come in contact with the bacteria. How bad your symptoms are depends on what type of Brucella is making you sick:
Your doctor will examine you. You may have:
Blood tests will be done to diagnose the infection and determine what type of Brucella is making you sick. Proper identification of the bacteria helps pinpoint the source of the infection.
Brucellosis can be difficult to treat. If you have brucellosis, your doctor will prescribe antibiotics. Antibiotics commonly used to treat brucellosis include:
You will generally be given doxycycline and rifampin a in combination for 6-8 weeks.
You must take the antibiotics for many weeks to prevent the disease from returning. The rate of relapse following treatment is about 5-15% and usually occurs within the first six months after treatment.
Recovery can take weeks, even months. Patients who receive treatment within one month of the start of symptoms can be cured of the disease.
Severe brucellosis may cause:
Brucellosis can cause long-lasting symptoms that are similar to systemic exertion intolerance disease. SEID is formerly known as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. The symptoms can lead to disability. They may include:
Brucellosis in a pregnant woman may lead to:
Death from brucellosis is uncommon. Most brucellosis-related deaths are due to endocarditis.
Brucellosis may be prevented with the following steps:
If you have come in contact with an animal infected with Brucella, tell your health care provider -- even if you do not have symptoms. You will need to be monitored for at least six months. There is no effective human vaccine to prevent brucellosis.
First Case Of Brucellosis In 30 Years Discovered At Farm
Brucellosis, a bacterial disease that can infect humans and animals, has been reported at a sheep farm in Pingtung County for the first time in more than 30 years, the Animal and Plant Health Inspection Agency (APHIA) said yesterday.
Three sheep raised at a farm in Jiouru Township (九如) were recently confirmed to have the disease during a routine annual inspection for brucellosis conducted by the Veterinary Research Institute, the APHIA said in a statement.
The farm was then disinfected and the infected animals culled, according to the agency, which said that the last time Taiwan reported a case of brucellosis in sheep was more than three decades ago.
Photo courtesy of the Pingtung County Government）
Even with these precautionary actions, the other 138 healthy sheep at the Jiouru farm will be required to undergo blood sampling for brucellosis every six weeks, the APHIA said.
If they do not test positive for the disease in the next 18 weeks, the farm would be able to return to a routine of one brucellosis test per year, it said.
APHIA deputy director-general Hsu Jung-pin (徐榮彬) yesterday said that Taiwan monitors sheep farms on an annual basis and said the Jiouru case was an isolated incident, as no other cases of
brucellosis have been detected.
The source of infection was still being investigated, Hsu said, noting that brucellosis not only infects sheep but also other animals such as dogs and cattle.
Brucellosis is a zoonotic disease normally caused by the ingestion of unpasteurized milk from infected animals or close contact with their secretions.
In Taiwan, brucellosis is listed as a Type B infectious animal disease under the Statute for Prevention and Control of Infectious Animal Diseases (動物傳染病防治條例).
Symptoms of the disease in sheep include inflammation of the reproductive organs and fetal membranes, miscarriage and infertility, the APHIA said.
The incubation period of this infection is about one week, but it can take several months before clinical symptoms appear.
The infection is rarely seen in humans, but its symptoms could include fever, body aches, headaches and fatigue, said Hwang Kao-pin (黃高彬), deputy chief of the China Medical University Hospital's Infection Control Center.
Although the fatality rate of a brucellosis infections is low, Hwang said it is difficult to diagnose clinically, as there are no specific symptoms, and patients do not easily recover from the illness without treatment.
There is a risk of death if patients are not treated appropriately with antibiotics, he said.
Compared with the common cold, brucellosis does not cause respiratory symptoms, the physician said.
Reminding poultry and livestock farmers that if they happen to run a fever for no apparent reason, they should proactively disclose their contact history when seeking treatment, Hwang said.
The last time Taiwan confirmed a case of brucellosis in humans was in 2015, and it involved someone who had arrived from abroad, Centers for Disease Control Deputy Director-General Philip Lo (羅一鈞) said.
How Brucellosis -- Which Can Jump From Animals To Humans -- Impacts The Brain
Brucellosis is a disease, caused by the members of bacterial Brucella family, that mainly infects cattle, goats and sheep, leading to pregnancy loss, which has caused billions of dollars in economic losses for livestock producers worldwide. The disease can also jump from animals to humans, mainly through consumption of unpasteurized dairy products or inhaling the spores from the tissues of infected animals.
While the disease can cause arthritis, inflammation of the heart and flu-like symptoms in humans, the bacteria can also enter the brain and cause neurobrucellosis, which can lead to long-term neurological complications, headaches, nausea, disorientation, swelling of the brain and sometimes death. Now, a new study at the University of Missouri has highlighted the protective power of both innate lymphoid cells and specific signaling proteins, known as interferons, in reducing the harmful neurological effects of Brucella.
The study, which was funded by the National Institutes of Health and used a mouse model, could potentially lead to future improvements in how the disease is both diagnosed and treated.
"While Missouri has been considered 'Brucellosis free' since 2004 and the bacteria has almost been completely eradicated in both humans and domestic animals nationwide, there are still areas where it persists like within bison in Yellowstone National Park," said Charles Moley, a veterinarian and current doctoral student in the MU College of Veterinary Medicine (CVM) who led the study in the lab of Jerod Skyberg, an associate professor in the CVM. "Worldwide, it is one of the most common bacterial infections that jumps from animals to humans, and there are estimates it impacts more than 10 million people each year, mainly in the Middle East and Mediterranean regions."
Moley is a veterinary scientist in the Comparative Medicine Program, and his research can potentially inform the work of other researchers by better understanding how the disease impacts the brain. Given the new knowledge of the critical protective role played by innate lymphoid cells and interferons, the study could lead to more targeted therapy interventions for humans worldwide suffering from neurobrucellosis or more targeted diagnostic approaches for identifying the disease before neurological symptoms appear or worsen.
"The work being done in MU's Laboratory for Infectious Disease Research improves the health of both animals and humans, which is gratifying," Moley said. "When I was recently visiting my grandparents in Arizona, I heard from a friend of my grandpa, who said his dad, who was a farmer, had died in the 1950s from brucellosis, and was thankful I was researching this topic. Stories like that motivate me, and I want to help."
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