Brucellosis in Pregnant Women

Abstract

Brucella species occasionally cause spontaneous human abortion, but theories regarding whether they do so more frequently than do other infectious pathogens remain controversial. We reviewed 92 pregnant women who presented with acute brucellosis at a Saudi Arabian hospital. From 1983 through 1995, the cumulative incidence of pregnancy and brucellosis was 1.3 cases per 1000 delivered obstetrical discharges. The incidence of spontaneous abortion in the first and second trimesters was 43%, and the incidence of intrauterine fetal death in the third trimester was 2%. Antepartum antimicrobial therapy with cotrimoxazole or cotrimoxazole/rifampin was protective against spontaneous abortion (relative risk, 0.14; 95% confidence interval, 0.06--0.37; P<.0001). The beneficial effect of treatment occurred in women with febrile illness; vaginal bleeding at presentation usually led to spontaneous abortion. This study demonstrated that the incidence of spontaneous abortion among pregnant women with brucellosis is high and that these women should receive prompt therapy with antimicrobial agents when they present for medical care.

The effects of maternal brucellosis on pregnancy outcome

“…Our current study shows a statistically significant difference in the incidence of abortion and the incidence of IUFD but not the incidence of preterm labour between pregnant women with positive brucellosis antibodies and control pregnant women. This is consistent with Malone et al (36), Makhseed et al (37) and Khan et al [35]; however, these results are contrary to the study of Seoud et al [17] who stated that Brucella infection has a lesser role in human abortion.…”

“…This result exceeds the 10% rate reported by Crisculo and di Carlo [29] and that of Sarram et al [32] who observed that among 51 pregnant women infected with brucellosis the incidence rate of abortion was only 11.6 %. Contrarily, the incidence rate of abortion in our study is less than that reported in other studies (Madkour et [33][34][35].…”

An old foe still with us: Troubling issues with brucellosis

“…Antimicrobial treatment at this point is extremely important for maternal and baby's health (27,28). Doxycycline and streptomycin are not recommended during pregnancy because of their teratogenicity.…”

Bartonella and Brucella--Weapons and Strategies for Stealth Attack

“…Symptoms of the acute phase of human brucellosis are flu-like periodic fevers with muscle and joint pain followed by lymphadenopathy, hepatosplenomegaly, and development of granulomas at multiple sites of the body (Franco et al 2007a). Common complications, some of which are fatal if not promptly diagnosed and treated, are arthritis, liver abscess formation, neurobrucellosis, endocarditis, and even abortion in the endemic regions (Khan et al 2001;Young 2005;Franco et al 2007b). …”