title: Human bovine tuberculosis - remains in the differential.
abstract: Mycobacterium bovis is a pathogen of cattle. The unpasteurized milk of affected cattle is a source of infection in humans. Despite the screening of cattle and the pasteurization of milk, M bovis has not been eradicated. A high index of clinical suspicion is needed in symptomatic patients with a history of possible exposure. At risk groups include animal workers, farmers, meat packers, vets and zoo keepers. Humans are usually infected by the aerosol route. We present two cases of human bovine tuberculosis. One was a presumptive case and the second was a confirmed case. Both responded well to antituberculous therapy. In the confirmed case, there was evidence of transmission to the partner living in the same house. Rifampicin prophylaxis was given to the exposed case. The M. bovis from the confirmed case was isoniazid resistant, in addition to having the well known resistance to pyrazinamide. Isoniazid resistance has been described before in those who are immunocompromised. We describe it in an immunocompetent patient.
authors.affiliation: Department of Respiratory Medicine, Naas General Hospital, Trinity College Dublin, Kildare, Ireland.
authors.forename: Shaukat
authors.initials: S
authors.lastname: Bilal
authors.affiliation: Department of Neurology, Adelaide and Meath Hospital, Trinity College Dublin, Dublin 24, Ireland.
authors.forename: Mudassir
authors.initials: M
authors.lastname: Iqbal
authors.affiliation: Department of Microbiology, Adelaide and Meath Hospital, Trinity College Dublin, Dublin 24, Ireland.
authors.forename: Philip
authors.initials: P
authors.lastname: Murphy
authors.affiliation: Department of Respiratory Medicine, Naas General Hospital, Trinity College Dublin, Kildare, Ireland.
authors.forename: Joan
authors.initials: J
authors.lastname: Power
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009163:Mycobacterium bovis / Q000302:isolation & purification*; D011718:Pyrazinamide / Q000494:pharmacology; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D007538:Isoniazid