title: Brucellosis in a renal transplant recipient.
abstract: Brucellosis is one of the most common systemic zoonotic diseases transmitted by consumption of unpasteurized dairy products or by occupational contact with infected animals. Brucellosis is rare in renal transplant recipients. Only 3 cases have been reported in the literature. We report a case of brucellosis with hematologic and hepatobiliary complications in a patient 3 years after renal transplantation. The mean time from transplantation to the diagnosis of brucellosis in these 4 reported patients was 5.1 years (range 17 months to 13 years). All patients had fever and constitutional symptoms, and all attained clinical cure after combination antibiotic therapy. Given the small number of patients, further study is needed to identify the characteristics of brucellosis in renal transplant recipients. Drug interactions and acute renal failure developed in our patient during antibiotic treatment. Therefore, we should monitor the levels of immunosuppressive agents frequently. Several studies have shown in vitro susceptibilities of Brucella melitensis to tigecycline. In our patient, fever finally subsided after tigecycline administration. The minimum inhibitory concentration of tigecycline using Etest was 0.094 μg/mL. Tigecycline may be a potential option for treatment of brucellosis in the setting of transplantation.
authors.affiliation: Kidney Institute, China Medical University Hospital, Taichung, Taiwan; School of Medicine China Medical University, Taichung, Taiwan.
authors.forename: I W
authors.initials: IW
authors.lastname: Ting
authors.forename: M W
authors.initials: MW
authors.lastname: Ho
authors.forename: Y J
authors.initials: YJ
authors.lastname: Sung
authors.forename: N
authors.initials: N
authors.lastname: Tien
authors.forename: C Y
authors.initials: CY
authors.lastname: Chi
authors.forename: H C
authors.initials: HC
authors.lastname: Ho
authors.forename: C C
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017347:Brucella melitensis / Q000187:drug effects* / Q000302:isolation & purification; D002006:Brucellosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007668:Kidney / Q000187:drug effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage / Q000031:analogs & derivatives; D000078304:Tigecycline; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage; D015047:Zoonoses
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D000078304:Tigecycline; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D008911:Minocycline
keywords: Brucella melitensis; brucellosis; renal transplantation; tacrolimus; tigecycline