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      Meningoencephalomyelitis Caused by Brucella canis: A Case Report and Literature Review

      case-report

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          Abstract

          Human brucellosis, one of the most common zoonoses worldwide, is rare in Japan. Brucella canis is the specific pathogen of human brucellosis carried by dogs. According to an epidemiological study of B. canis infection in Japan, B. canis is the specific pathogen of human brucellosis in dogs. We herein report a rare case of meningoencephalomyelitis caused by B. canis in a 68-year-old Japanese man. Neurobrucellosis was diagnosed based on a serum tube agglutination test and abnormal cerebrospinal fluid findings. The patient was started on targeted treatment with a combination of doxycycline and streptomycin. Although extremely rare, neurobrucellosis should be considered in patients with a fever of unknown origin and unexplained neurological symptoms.

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          Human brucellosis.

          Maria Franco, Maximilian Mulder, Robert Gilman … (2007)
          Human brucellosis still presents scientists and clinicians with several challenges, such as the understanding of pathogenic mechanisms of Brucella spp, the identification of markers for disease severity, progression, and treatment response, and the development of improved treatment regimens. Molecular studies have shed new light on the pathogenesis of Brucella spp, and new technologies have permitted the development of diagnostic tools that will be useful in developing countries, where brucellosis is still a very common but often neglected disease. However, further studies are needed to establish optimum treatment regimens and local and international control programmes. This Review summarises current knowledge of the pathogenic mechanisms, new diagnostic advances, therapeutic options, and the situation of developing countries in regard to human brucellosis.
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            The new global map of human brucellosis.

            Georgios Pappas, Photini Papadimitriou, Nikolaos Akritidis … (2006)
            The epidemiology of human brucellosis, the commonest zoonotic infection worldwide, has drastically changed over the past decade because of various sanitary, socioeconomic, and political reasons, together with the evolution of international travel. Several areas traditionally considered to be endemic--eg, France, Israel, and most of Latin America--have achieved control of the disease. On the other hand, new foci of human brucellosis have emerged, particularly in central Asia, while the situation in certain countries of the Near East (eg, Syria) is rapidly worsening. Furthermore, the disease is still present, in varying trends, both in European countries and in the USA. Awareness of this new global map of human brucellosis will allow for proper interventions from international public-health organisations.
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              Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature.

              Turan Buzgan, Mustafa Kasım Karahocagil, Hasan Irmak … (2010)
              Brucellosis is the most prevalent bacterial zoonosis worldwide. In this study, we aimed to compare our 1028 brucellosis cases with other big series in the literature in view of epidemiological, clinical, and laboratory findings and therapeutic features. A total of 1028 brucellosis cases admitted to the Department of Infectious Diseases and Clinical Microbiology over a 10-year period were included in the study. A retrospective analysis was undertaken and patient files were reviewed for history, clinical and laboratory findings, and therapeutic features, as well as complications. Of the 1028 patients, 539 (52.4%) were female and 489 (47.6%) were male. The mean age of patients was 33.7+/-16.34 years and 69.6% of cases were aged 13-44 years. Four hundred and thirty-five cases (42.3%) had a history of raising livestock and 55.2% of the cases were found to have no occupational risk for brucellosis. Six hundred and fifty-four of the cases (63.6%) had a history of raw milk and dairy products consumption. The most frequently seen symptoms were arthralgia (73.7%) and fever (72.2%), while the most common clinical findings were fever (28.8%) and hepatomegaly (20.6%). The most frequent laboratory finding was a high C-reactive protein level (58.4%). The standard tube agglutination (STA) test+Coombs STA test was positive in 1016 cases (98.8%). Focal involvement was present in 371 (36.1%) cases. The most frequent involvement was osteoarticular involvement with 260 cases (25.3%). The overall relapse rate for patients with brucellosis was 4.7%. The highest relapse rate, 8.5%, was observed in the group of patients with osteoarticular involvement. Regimens including doxycycline and streptomycin with or without rifampin appeared more effective than other regimens in osteoarticular involvement. In humans, brucellosis may lead to serious morbidity, and it continues to be a major health problem in Turkey. There is no recommended treatment protocol for complicated brucellosis. Large multicenter studies are needed to determine the most appropriate treatment choices and durations in complicated brucellosis. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Intern Med
                Journal ID (iso-abbrev): Intern Med
                Title: Internal Medicine
                Publisher: The Japanese Society of Internal Medicine
                ISSN (Print): 0918-2918
                ISSN (Electronic): 1349-7235
                Publication date (Electronic): 6 November 2023
                Publication date (Print): 15 June 2024
                Volume: 63
                Issue: 12
                Pages: 1823-1827
                Affiliations
                [1 ]Division of Neurology, Department of Medicine, Nihon University School of Medicine, Japan
                [2 ]Department of Neurology, Faculty of Medicine, Shimane University, Japan
                [3 ]Department of Veterinary Science, National Institute of Infectious Diseases, Japan
                [4 ]Department of Neurology, Masuda Red Cross Hospital, Japan
                [5 ]Department of Emergency and Disaster Medicine, Graduate School of Medicine, Juntendo University, Japan
                [6 ]Department of Neurology, Heisei Memorial Hospital, Japan
                [7 ]Shimane Prefecture Bureau, Shimane Prefectural Central Hospital, Japan
                Author notes

                Correspondence to Dr.　Masaki Ishihara, ishihara.masaki@ 123456nihon-u.ac.jp

                Article
                DOI: 10.2169/internalmedicine.2664-23
                PMC ID: 11239261
                PubMed ID: 37926538
                SO-VID: 2ba39e2a-2d00-48fd-be5b-9fc7b214c481
                Copyright © Copyright © 2024 by The Japanese Society of Internal Medicine
                License:

                The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit ( https://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 24 July 2023
                Date accepted : 18 September 2023
                Categories
                Subject: Case Report

                Keywords: neurobrucellosis,brucella canis,meningoencephalomyelitis,fever of unknown origin,doxycycline,streptomycin
                Data availability:
                Keywords: neurobrucellosis, brucella canis, meningoencephalomyelitis, fever of unknown origin, doxycycline, streptomycin

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