title: Brucella melitensis sternal osteomyelitis following median sternotomy.
abstract: Human brucellosis, a zoonotic infection, may present with a range of symptoms but is rarely described as a cause of surgical site infections. We present the first reported case of Brucella melitensis causing sternal osteomyelitis of a midline sternotomy for a coronary artery bypass graft. The operation was performed in a non-endemic country but the patient had travelled to Syria immediately before surgery, where the infection was assumed to have been acquired. The infection resolved following treatment with doxycycline, rifampicin and gentamicin. We review the literature for surgical site infections related to Brucella species and discuss the infection control implications. Human brucellosis has the potential to cause surgical site infections and it should be in the differential diagnosis of any patient with a relevant exposure history presenting with a febrile illness and musculoskeletal findings.
authors.affiliation: Department of Microbiology, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom. Electronic address: toongchin@doctors.net.uk.
authors.forename: Yoon T
authors.initials: YT
authors.lastname: Chin
authors.affiliation: Cardiac Surgery Unit, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom. Electronic address: monica.krishnan@cmft.nhs.uk.
authors.forename: Monica
authors.initials: M
authors.lastname: Krishnan
authors.affiliation: Department of Microbiology, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom. Electronic address: phillipa.burns@cmft.nhs.uk.
authors.forename: Phillipa
authors.initials: P
authors.lastname: Burns
authors.affiliation: Department of Microbiology, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom. Electronic address: ahmed.qamruddin@cmft.nhs.uk.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Qamruddin
authors.affiliation: Cardiac Surgery Unit, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom. Electronic address: ragheb.hasan@cmft.nhs.uk.
authors.forename: Ragheb
authors.initials: R
authors.lastname: Hasan
authors.affiliation: Department of Microbiology, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom. Electronic address: andrew.dodgson@cmft.nhs.uk.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Dodgson
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017347:Brucella melitensis / Q000187:drug effects / Q000302:isolation & purification*; D002006:Brucellosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology*; D056346:Sternotomy / Q000009:adverse effects* / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents
keywords: Brucella melitensis; Brucellosis; Osteomyelitis; Sternotomy; Surgical site infection