Brucellosis complicating chronic non-infectious disorders: diagnostic and therapeutic dilemmas.
There is little information in the literature on the clinical progress of brucellosis in patients affected by other non-infectious diseases; however, the infection can often trigger an exacerbation of existing underlying conditions in certain target organs. In this report we present four cases of brucellosis complicating previous diseases, and the difficulties in relation to their diagnosis and treatment. The study involved four patients with the following disorders: polycythaemia vera, pulmonary fibrosis, cirrhosis of the liver and arthritis of the knee. Brucellosis was diagnosed by classical serological and bacteriological methods. The strains involved could be isolated only in three of the four patients: two strains were Brucella abortus biovar 1 and one was Brucella suis biovar 1. Two patients relapsed 10 and 7 months after admission, another presented chronic brucellosis and received various therapy schemes, and one died. Since the best selection of antibiotics and the optimal duration of therapy remain unknown for patients having brucellosis complicated by previous pathologies, these remain at the discretion of the attending physician. Management of our patients was controversial in terms of the selection of antibiotics, duration of treatment and decision regarding surgery.
Jacob
Néstor R
NR
Infectología, Hospital Cosme Argerich, Margall 750, 1155 Buenos Aires, Argentina.
Rodríguez
Claudia G
CG
Infectología, Hospital Cosme Argerich, Margall 750, 1155 Buenos Aires, Argentina.
Binaghi
María A
MA
Hematología, Hospital de Clínicas José de San Martín, Avda Córdoba 2300, Buenos Aires, Argentina.
Scapellato
Pablo G
PG
Infectología, Hospital Donación Francisco Santojanni, Pilar 950, 1407 Buenos Aires, Argentina.
Rosales Ostriz
María B
MB
Hematología, Hospital de Clínicas José de San Martín, Avda Córdoba 2300, Buenos Aires, Argentina.
Ayala
Sandra M
SM
Administración Nacional de Laboratorios e Institutos de Salud Dr C. G. Malbrán (ANLIS), Avda Velez Sarsfield 563, 1281 Buenos Aires, Argentina.
Lucero
Nidia E
NE
Administración Nacional de Laboratorios e Institutos de Salud Dr C. G. Malbrán (ANLIS), Avda Velez Sarsfield 563, 1281 Buenos Aires, Argentina.
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001168:Arthritis / Q000150:complications*; D002006:Brucellosis / Q000150:complications* / Q000188:drug therapy; D002908:Chronic Disease; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011087:Polycythemia Vera / Q000150:complications*; D011658:Pulmonary Fibrosis / Q000150:complications*
D000900:Anti-Bacterial Agents