title: Brucella Melitensis As Causative Agent for Neck Abscess in an Endemic Area.
abstract: Brucellosis, a zoonotic disease, is very common in the Mediterranean basin and a major concern in livestock areas. We present a rare case of aBrucella-caused abscess in the neck of a stock-breeder in an endemic Greek area.
  
  
  
  A 39-year-old male, living in the rural area of Thessaly, presented with a mass in the left area of his neck. Clinical examination and imaging tests revealed an abscess in the left sternocleidomastoid muscle. Sampling of the abscess by fine-needle aspiration yielded inflammatory fluid (17x103cells/μL). Molecular sequencing (16S rRNA polymerase chain reaction) performed directly in the clinical sample identified the presence ofBrucella melitensiswithin 24 hours after material sampling. The microorganism was isolated in agar media four days later. The Rose-Bengal test was negative, while the Brucellacapt test showed titer 1/320. Given the results obtained with these molecular techniques, the patient was offered treatment with streptomycin (1 g for 3 weeks) and oral doxycycline (100 mg twice daily for 6 weeks), concurrently.
  
  
  
  In areas endemic for brucellosis, the investigation of a patient with a neck abscess should includeBrucellaspp. among possible causative agents.
authors.affiliation: Department of Microbiology, University Hospital of Larissa, Larissa, Greece.
authors.forename: Styliani
authors.initials: S
authors.lastname: Sarrou
authors.affiliation: Department of Otorhinolaryngology, University Hospital of Larissa, Larissa, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Skoulakis
authors.affiliation: Department of Otorhinolaryngology, University Hospital of Larissa, Larissa, Greece.
authors.forename: Jiannis
authors.initials: J
authors.lastname: Hajiioannou
authors.affiliation: Department of Microbiology, University Hospital of Larissa, Larissa, Greece.
authors.forename: Efi
authors.initials: E
authors.lastname: Petinaki
authors.affiliation: Department of Otorhinolaryngology, University Hospital of Larissa, Larissa, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Bizakis
mesh_terms: D000038:Abscess / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017347:Brucella melitensis / Q000187:drug effects / Q000472:pathogenicity; D002006:Brucellosis / Q000150:complications* / Q000175:diagnosis*; D004318:Doxycycline / Q000627:therapeutic use; D019353:Endemic Diseases; D006041:Goats / Q000382:microbiology; D006115:Greece; D006801:Humans; D008297:Male; D009333:Neck / Q000503:physiopathology*; D016133:Polymerase Chain Reaction / Q000379:methods; D012756:Sheep / Q000382:microbiology; D013307:Streptomycin / Q000627:therapeutic use; D015047:Zoonoses / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline; D013307:Streptomycin
keywords: Brucella melitensis; molecular microbiology; neck abscess