1/10. Spinal brucellosis: case report in the united states.STUDY DESIGN: Case report. OBJECTIVE: To increase awareness of spinal brucellosis and discuss demographics, diagnosis, and treatment. SUMMARY OF BACKGROUND DATA: brucellosis is a rare cause of spinal infections in the united states, although there have been regional increases in its prevalence. methods: Retrospective review of a patient with spinal brucellosis. She underwent a protracted course of treatment, with a long delay in diagnosis. history ultimately revealed regular consumption of unpasteurized goat cheese. Appropriate testing subsequently led to the diagnosis. RESULTS: After multiple surgeries and medications, the condition responded well to definitive antibiotic therapy. CONCLUSION: brucellosis is rare in the united states and thus often overlooked in the differential diagnosis of back pain. The changing risk pattern for this disease requires a high index of suspicion, which can result in early diagnosis and predictably favorable results to treatment.- - - - - - - - - - ranking = 1keywords = goat (Clic here for more details about this article) |
2/10. Lumbar pain in a married couple who likes cheese: brucella strikes again!A 69-year-old man living in Florence reported fever and acute lumbar pain one month after transurethral resection of a superficial transitional cell carcinoma of the bladder. The radionuclide bone scan suggested metastatic lesions of the L3-L4 vertebrae. However cobalt treatment was ineffective. A bone biopsy of L4 showed an inflammatory pattern and antibiotic therapy was started which did not produce any clinical improvement. Six months after the onset of the back pain brucellar spondylitis was serologically diagnosed and treatment with doxycycline and streptomycin produced a significant clinical and radiological improvement. After 2 months the patient's wife presented with fever and lumbar pain, and brucellar spondylitis was diagnosed as well. An extensive epidemiological examination revealed that 8 months earlier the family had eaten unpasteurized goat cheese and serological examination of the entire family showed that 3 out of 4 members had significant titres of brucellar antibodies. Finally it was discovered that 4 months after consuming the cheese the third infected subject experienced an episode of epidydimoorchitis for which no diagnosis and effective treatment was found. This family cluster of brucellar infection indicates that a high degree of suspicion in the diagnosis of brucellosis is necessary even in non-endemic areas, to reduce the delay in the diagnosis and treatment of the disease and to prevent the occurrence of complications that may prove difficult to treat.- - - - - - - - - - ranking = 1keywords = goat (Clic here for more details about this article) |
3/10. Acute brucella meningomyeloencephalo-spondylosis in a teenage male.BACKGROUND: brucellosis has been known from the time of Hippocrates. In 1885 Sir David Bruce isolated the causative organism from the spleens of soldiers who had died from "malta disease" (now brucellosis). There are 4 species of brucella pathogenic to humans and each of them has a specific types of animal reservoir: B.arbotus (cattle, buffalo), B.melitensis (goats, sheep, camels), B.suis (pigs), B.canis (dogs). humans are infected when they are exposed to body fluids from an infected animal. The symptoms and signs of brucellosis are protean. Diagnosis is usually dependent on clinical features and serology or culture. OBJECTIVES: To describe a case of neurobrucellosis, raise awareness about the existence of the disease in uganda and africa in general and share our experiences in its diagnosis and management. methods: A male teenager was admitted with symptoms and signs of an acute meningo-encephalitis. He underwent clinical, laboratory and basic radiological evaluation. RESULTS: The un-incubated brucella titer was significantly reactive(1:160).Oblique-view cervical x-rays showed early osteophyte formation with encroachment on the vertebral foramina on the left hand side. A diagnosis of acute brucella meningomyeloencephalo-spondylosis was made and the patient was successfully treated using conventional therapy for brucellosis (oral doxycycline for 6weeks and IM streptomycin for 2 weeks). CONCLUSIONS: Neurobrucellosis though said to be rare, is a reality in our health units should be considered in the differential diagnosis of neurological and psychiatric illnesses. The good news is that it is curable and is responsive to drugs used for other forms of brucellosis.- - - - - - - - - - ranking = 1keywords = goat (Clic here for more details about this article) |
4/10. A case of human brucellosis in hong kong.brucellosis is an infectious disease of humans and animals caused by Brucella species. We report on a 34-year-old housewife who presented with recurrent headache, fever, and malaise. Blood cultures yielded slow-growing gram-negative coccobacilli that were later identified as brucella melitensis. The patient recalled handling goat placenta in china. She was prescribed a 6-week course of doxycycline and rifampicin. Laboratory staff who had been exposed to the isolate remained asymptomatic. The epidemiology, diagnosis, and treatment of brucellosis are discussed.- - - - - - - - - - ranking = 1keywords = goat (Clic here for more details about this article) |
5/10. Brucella meningitis and papilledema in a child.PURPOSE: To report a rare case of Brucella meningitis with papilledema in a child and to discuss the findings of neurobrucellosis in children. methods: A 6-year-old girl was admitted with headache, fever, and vomiting for 1 week. Her family reported intake of raw unpasteurized goat's milk in the past. Meningeal signs were strongly positive. Bilateral moderate optic disc edema with flame-shaped hemorrhages was observed. RESULTS: The diagnosis of Brucella infection was established by positive blood culture for Brucella species, serum agglutination titer of antibodies to Brucella >1:160, and positive CSF culture. After treatment consisting of trimethoprim-sulfamethoxazole, rifampin, and doxycycline, the patient's condition gradually improved. One month later, the papilledema disappeared. One year after presentation, the patient remains free of symptoms. CONCLUSIONS: Brucella meningitis must be ruled out in symptomatic patients reporting ingestion of raw unpasteurized goat's milk. papilledema is a frequent clinical feature, but irreversible visual impairment is extremely rare.- - - - - - - - - - ranking = 2keywords = goat (Clic here for more details about this article) |
6/10. Brucella endocarditis in prosthetic valves.Human brucellosis is a multiple organ disease that presents with fever and is most often transmitted via contaminated, unpasteurized goat milk and cheese. In chronic cases, focal complications (eg, spondylitis, neurobrucellosis and endocarditis) are frequently seen. Although the disease may be severely debilitating, the mortality rate is low. Fatal cases are often due to endocarditis. Because Brucella endocarditis is a rare complication (2% to 5%), therapeutic considerations are based on single-case experiences only. Therapy includes long-term antibiotic treatment using combinations of various antimicrobial drugs and surgical valve replacement when required. A case of Brucella endocarditis complicated by the infection of two valvular prostheses implanted after involvement of the mitral and aortic valve due to rheumatic fever is described. The patient was successfully treated by a medical and surgical approach. Therapeutic strategies in Brucella endocarditis are discussed in light of the current literature.- - - - - - - - - - ranking = 1keywords = goat (Clic here for more details about this article) |
7/10. Brucella meningitis.A 36-year-old Hispanic man came into the emergency department with nonspecific symptoms (headache, myalgias, low-grade temperature, and low white blood cell count) and was diagnosed with brucella meningitis. The patient said he had consumed unpasteurized goat's milk and cheese in mexico, and had been treated 3 months previously for a febrile illness diagnosed as malta fever (brucellosis). Cultures of both the blood and cerebrospinal fluid yielded brucella melitensis. Blood agglutinin results for B abortus were positive at greater than 1:160. Unpasteurized milk and cheese are consumed in many countries where brucellosis is endemic. Emergency physicians are occasionally confronted with patients from developing countries with diseases that require rapid and specific diagnosis for optimal treatment.- - - - - - - - - - ranking = 1keywords = goat (Clic here for more details about this article) |
8/10. Acute brucella ileitis.Human brucellosis is an enteric fever in which systemic symptoms are generally more prominent than gastrointestinal complaints. During an outbreak of infection caused by brucella melitensis, linked to ingestion of unpasteurized goat milk cheese, we treated a child with radiographic evidence of acute ileitis. Alimentary tract involvement in brucellosis is reviewed.- - - - - - - - - - ranking = 1keywords = goat (Clic here for more details about this article) |
9/10. brucellosis.The possibility of brucellosis should be considered in any case of obscure pyrexia, monoarthritis, fascitis or splenomegaly, especially in persons who have been in contact with cattle, pigs or goats, or who have recently visited the mediterranean region or East africa. tetracycline controls the symptoms, and the addition of streptomycin reduces the tendency to relapse.- - - - - - - - - - ranking = 1keywords = goat (Clic here for more details about this article) |
10/10. endocarditis caused by brucella melitensis.OBJECTIVE: To describe the management of an uncommon but serious infection in australia. CLINICAL FEATURES: A 25-year-old woman developed endocarditis after residence in turkey and consumption of goat dairy products. brucella melitensis was isolated from blood cultures. INTERVENTION AND OUTCOME: The valve remained infected after prolonged intravenous administration of trimethoprim-sulfamethoxazole, gentamicin and rifampicin. Uncontrolled sepsis and worsening haemodynamic function necessitated valve replacement. To date the patient remains well while taking trimethoprim-sulfamethoxazole and rifampicin. CONCLUSION: endocarditis due to Brucella spp. is uncommon in australia. This infection is difficult to cure with antimicrobial therapy alone and early surgical intervention is advisable.- - - - - - - - - - ranking = 1keywords = goat (Clic here for more details about this article) |
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