Unveiling the unusual: a fatal case of brucellosis with multi-organ involvement
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20240915Keywords:
Brucella melitensis, omp31, Neurobrucellosis, PCRAbstract
Brucellosis in humans is one of the most common zoonoses. The infection is caused by various species of Brucella bacteria. Brucella infections frequently affect several organ systems with vague clinical symptoms. Humans typically acquire brucellosis through direct contact with infected animals or consumption of contaminated animal products like unpasteurized dairy. It poses significant clinical challenges due to its varied presentation. The disease manifests with a range of nonspecific symptoms including fever, sweating, fatigue, joint and muscle pain, and loss of appetite. Brucellosis can also affect various organs such as the liver, spleen, heart, and nervous system. Diagnosis often involves blood cultures, serological tests, and polymerase chain reaction (PCR) assays to detect the bacteria or antibodies produced by the immune system. This case report presents the clinical course of patient X, a 58-year-old female who succumbed to death following an unusual presentation of brucellosis. Despite initial diagnostic challenges, the identification of Brucella melitensis in her blood marked a critical turning point. The case highlights the importance of considering Brucellosis in patients with persistent fever and multi-organ involvement, emphasizing the need for early recognition and appropriate management.
Metrics
References
Orihel TC, Eberhard ML. Zoonotic filariasis. Clin Microbiol Rev. 1998;11(2):366-81.
Pampiglione S, Canestri Trotti G, Rivasi F. Human dirofilariasis due to Dirofilaria (Nochtiella) repens: a review of world literature. Parassitologia. 1995;37:149-93.
Canestri Trotti G, Pampiglione S, Rivasi F. The species of the genus Dirofilaria, Railliet and Henry, 1911. Parassitologia. 1997;39:369-74.
Padmaja P, Kanagalakshmi Samuel R, Kuruvilla PJ, Mathai E. Subcutaneous dirofilariasis in southern India: a case report. Ann Trop Med Parasitol. 2005;99:437-40.
Simón F, Siles-Lucas M, Morchón R, González-Miguel J, Mellado I, Carretón E, et al. Human and animal dirofilariasis: the emergence of a zoonotic mosaic. Clin Microbiol Rev. 2012;25(3):507-44.
Winkler S, Pollreisz A, Georgopoulos M, Bagò-Horvath Z, Auer H, Walochnik J, et al. Candidatus Dirofilaria hongkongensis as causative agent of human ocular filariosis after travel to India. Emerg Infect Dis. 2017;23(8):1428.
Poppert S, Hodapp M, Krueger A, Hegasy G, Nieson WD, Kern WV, et al. Dirofilaria repens infection and concomitant meningoencephalitis. Emerg Infect Dis. 2009;15:1844-6.
Addario C. Su un nematode dell’occhio umano. Ann Ottalmol. 1885;13:135-7.
Sabu L, Devada K, Subramanian H. Dirofilariosis in dogs and humans in Kerala. Indian J Med Res. 2005;121:691-3.
Joseph E, Mathai A, Abraham LK, Thomas S. Subcutaneous human dirofilariasis. J Parasit Dis. 2011;35:140-3.
Nath R, Gogoi R, Bordoloi N, Gogoi T. Ocular dirofilariasis. Indian J Pathol Microbiol. 2010;53:1579.
Sathyan P, Manikandan P, Bhaskar M, Padma S, Singh G, Appalaraju B. Subtenons infection by Diroflaria repens. Indian J Med Microbiol. 2006;24:612.
Sekhar HS, Srinivasa H, Batru RR, Mathai E, Shariff S, Macaden RS. Human ocular diroflariasis in Kerala Southern India. Indian J Pathol Microbiol. 2000;43:779.
Dissanaike AS, Abeyewickreme W, Wijesundera MD, Weerasooriya MV, Ismail MM. Human dirofilariasis caused by Dirofilaria (Nochtiella) repens in Sri Lanka. Parassitologia. 1997;39:375-82.
Simón F, Siles-Lucas M, Morchón R, González-Miguel J, Mellado I, Carretón E, et al. Human and animal dirofilariasis: the emergence of a zoonotic mosaic. Clin Microbiol Rev. 2012;25(3):507-44.
Grandi G, Morchon R, Kramer L, Kartashev V, Simon F. Wolbachia in Dirofilaria repens, an agent causing human subcutaneous dirofilariasis. J Parasitol. 2008;94:1421-3.
Genchi C, Kramer LH, Sassera D, Bandi C. Wolbachia and its implications for the immunopathology of filariasis. Endocr Metab Immune Disord Drug Targets. 2012;12:53-6.
Kotigadde S, Ramesh SA, Medappa KT. Human dirofilariasis due to Dirofilaria repens in southern India. Trop Parasitol. 2012;2:67-8.
Sanjeev H, Rajini M, Prasad SR. Human dirofilariasis: An uncommon case of subcutaneous infection with dirofilaria repens with a brief review of literature. Nitte Univ J Health Sci. 2011;1:60-2.
Nadgir S, Tallur SS, Mangoli V, Halesh LH, Krishna BV. Subconjunctival dirofilariasis in India. Southeast Asian J Trop Med Public Health. 2001;32(2):244-6.
Cancrini G, Prieto G, Favia G, Giannetto S, Tringali R, Pietrobelli M, et al. Serological assays on eight cases of human dirofilariasis identified by morphology and DNA diagnostics. Ann Trop Med Parasitol. 1999;3:147-52.
Jelinek T, Schulte-Hillen J, Loscher T. Human Dirofilariasis. Int J Dermatol. 1996;35(12):872-5.
