title: Treatment of brucellosis in a young child with trimethoprim/sulfamethoxazole anaphylaxis.
abstract: Brucellosis is a common zoonotic disease throughout the world. Brucella spp. transmit to humans through contact with fluids of infected animals, especially sheep, cattle, and goats. It is also transmitted by ingestion of fluid-derived products of infected animals, such as unpasteurized milk and cheese. Brucella spp. changes pH level of intracellular environment, so the first treatment approach is to administer antibiotics that have activity in acidic conditions. Anti-brucellosis treatment regimens include doxycycline for children older than eight years old and rifampicin and trimethoprim/sulfamethoxazole (TMP-SMX) combination therapy for children under eight years old, which may be able to act intracellularly under acidic conditions. A TMP-SMX allergy causing anaphylaxis has been reported previously. No alternative anti-brucellosis treatments have been reported in the literature for patients under eight years old with a TMP-SMX allergy. Here, we report a case of a child with brucellosis and a TMP-SMX allergy who was under eight years old at the time of diagnosis and was successfully treated with rifampicin, ciprofloxacin, and gentamicin.
authors.affiliation: Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Department of Pediatrics, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Teker
authors.affiliation: Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Division of Pediatric Infectious Diseases, Turkey.
authors.forename: Gonul
authors.initials: G
authors.lastname: Tanir
authors.affiliation: Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Division of Pediatric Allergy and Immunology, Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Ozmen
authors.affiliation: Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Division of Pediatric Infectious Diseases, Turkey. Electronic address: turkanteke@gmail.com.
authors.forename: Turkan Aydın
authors.initials: TA
authors.lastname: Teke
authors.affiliation: Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Division of Pediatric Allergy and Immunology, Turkey.
authors.forename: Sennur
authors.initials: S
authors.lastname: Keles
authors.affiliation: Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Division of Pediatric Allergy and Immunology, Turkey.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Bostancı
mesh_terms: D000707:Anaphylaxis; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002006:Brucellosis / Q000188:drug therapy*; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000627:therapeutic use*; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D012293:Rifampin / Q000627:therapeutic use*; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002939:Ciprofloxacin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D012293:Rifampin
keywords: Anaphylaxis; Brucellosis; Children; Trimethoprim/sulfamethoxazole