Brucellosis in renal transplant recipients: a comparative review of 5 cases

Inayat, Faisal; Mahboob, Muddassar; Ali, Nouman Safdar; Bokhari, Syed Rizwan A.; Ashraf, Attia

doi:10.1136/bcr-2018-225865

Cited by 7 publications

(10 citation statements)

References 16 publications

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“…There are a few reported cases of Brucella infection post solid organ transplantation, mostly in renal transplant patients [7][8][9][10], liver transplant patients [11][12][13], and in one cardiac transplant patient [14]. These cases are summarized in Table 3.…”

Section: Discussionmentioning

confidence: 99%

First Case of Brucella Pneumonia in a Lung Transplant Patient: Case Report and Review of the Literature

Abed

Almaghrabi

Nizami

2020

Cureus

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Brucella is one of the most common zoonotic diseases worldwide. It is endemic in the Mediterranean basin. Brucella pneumonia is a rare complication of brucellosis that can present with a variety of clinical and radiological manifestations. It was described only once previously in the setting of solid organ transplant. A 32-year-old female from Saudi Arabia with cystic fibrosis and bronchiectasis presented five weeks after a bilateral lung transplant with fever and cough. Investigation showed high inflammatory markers in addition to a pulmonary infiltrate in the chest imaging. All microbiological workups were negative including bronchoalveolar lavage cultures. Brucella serology was positive and she was started on anti-Brucella therapy which resulted in complete resolution of her symptoms and radiological changes. This case demonstrates an unusual presentation of Brucellosis. It highlights the importance of epidemiology in evaluating posttransplant infections. We reviewed and summarized the literature on brucellosis post solid organ transplant and the various treatment regimens for Brucella pneumonia. This is the first case report of Brucella pneumonia in a lung transplant patient. Brucella is a rare complication post solid organ transplant but it has a good prognosis.

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Section: Discussionmentioning

confidence: 99%

First Case of Brucella Pneumonia in a Lung Transplant Patient: Case Report and Review of the Literature

Abed

Almaghrabi

Nizami

2020

Cureus

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“…All of the cases presented with a typical peritoneal infection with neutrophil predominance with a positive culture in 5−21 days [19]. Organ involvement is hematogenous in most of the studies; however, Osizik et al [20] showed a positive peritoneal fluid culture with a negative blood culture and serology. They proposed a direct inoculation of bacteria from the catheter to peritoneum based on the patient's occupation.…”

Section: Brucellosis In Peritoneal Dialysis (Pd) Patientsmentioning

confidence: 98%

“…There were two reports of neurobrucellosis in renal Tx patients in the literature, one with loss of consciousness and encephalitis [24] and the other one with a seizure and headache [25]. Endocarditis [26], pulmonary involvement [27], hepatobiliary and hematologic [28], pyelonephritis and dysuria [29], and arthritis [30] were other presentations of the disease. They were diagnosed based on serology or fluid culture that finally guided to the diagnosis of brucellosis.…”

Section: Brucellosis In Renal Transplant Recipientsmentioning

confidence: 99%

Kidney Disease in Brucellosis

Savaj¹

2020

New Insight Into Brucella Infection and Foodborne Diseases

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Brucellosis, a prevalent zoonosis disease in different countries, can involve the kidney during infection and also present in the complicated form in hemodialysis (HD), peritoneal dialysis (PD), and kidney transplant (Tx) patient. In spite of few reports of kidney involvements in the literature, this infection can imitate a wide range of glomerular disease from minimal change, membranous glomeropathy, focal and diffuse proliferative glomerular disease to rapidly progressive glomerulonephritis. Cryoglobulinemia, thrombotic microangiopathy, and ANCA-associated glomerular disease are vasculitis form of the disease. Tubulointerstitial involvement, electrolyte disorder, renal abscess, and pyelonephritis can present the same as other Gram-negative infections. Moreover, peritonitis in PD patient, spondyloarthropathy in HD, and severe infection in kidney Tx patients have been reported. Infection recurrence and infection from kidney donors are another dilemma in renal recipients. Brucellosis as a multifaced disease can mimic a wide range of presentations in nephrology. Clinicians should keep in mind the diverse pictures of the disease, especially when they practice in the endemic area.

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“…Hepatic complications are expected in brucellosis, and so, it is, thus, not surprising that it can react by ascites formation even in previously healthy patients or in the context of generalized fulminant disease course in patients with chronic liver involvement [9]. e symptoms and signs of brucellosis are highly variable, especially in immunosuppressed populations [1].…”

Section: Case Reports In Infectious Diseasesmentioning

confidence: 99%

“…Four of the six defined Brucella species in animals are pathogenic to humans. Brucella melitensis is the most common and the most virulent bacterium that causes human disease [ 9 ]. The infection caused by Brucella melitensis is characterized by chronic and recurrent infections [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Fatal Brucellosis Infection in a Liver Transplant Patient: A Case Report and Review of the Literature

Piedrahita

Martinez-Valencia

Rojas

et al. 2021

Case Reports in Infectious Diseases

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Brucellosis is the most common zoonosis, particularly in developing countries. The true incidence of human brucellosis is unknown. The WHO points out that 500,000 cases of brucellosis are reported each year from around the world. In Colombia, there is currently no regular surveillance of the event in humans and its prevalence is low due a low clinical suspicion. We report a case of a 66-year-old man, an urban merchant, who had received a liver transplant 11 years ago. The patient presented to the emergency department for two months of fatigue, severe myalgia, paresis of the extremities, loss of muscle strength, and progressive deterioration of functional class. In the emergency room, he became disoriented and was transferred to the intensive-care unit. He had a white blood cell count of 18990/uL and creatine phosphokinase 10302 U/L. Routine blood cultures were positive for Brucella melitensis. The patient reported consumption of unpasteurized bovine milk. He was treated with doxycycline and ciprofloxacin. Despite antibiotic management, after one month of hospitalization and in the context of septic shock with multiorgan failure, the patient died. Brucellosis is an unsuspected and underdiagnosed disease. It can occur in people with or without risk factors. Although the mortality is low, immunocompromised patients can develop fatal infections. A presumptive diagnosis can be established through the correlation of patient history and classic laboratory findings, which include transaminitis, anemia, and leukopenia with relative lymphocytosis; however, other findings can help us to guide the diagnosis, such as rhabdomyolysis, which appears as a complication in different infections; however, it had not been described before in brucellosis. A partnership between clinical suspicion laboratory diagnostic tests and improved disease surveillance systems is necessary to fight the disease.

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Brucellosis in renal transplant recipients: a comparative review of 5 cases

Cited by 7 publications

References 16 publications

First Case of Brucella Pneumonia in a Lung Transplant Patient: Case Report and Review of the Literature

First Case of Brucella Pneumonia in a Lung Transplant Patient: Case Report and Review of the Literature

Kidney Disease in Brucellosis

Fatal Brucellosis Infection in a Liver Transplant Patient: A Case Report and Review of the Literature

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