Epidemiological features of brucellosis and factors affecting its treatment failure and relapse in Qom Province, Iran

Mohammadbeigi, Abolfazl; Saghafipour, Abedin; Hamta, Amir; Khazaei, Salman; Maghsoudi, Atefeh; Shams, Saeed

doi:10.4314/gmj.v55i3.5

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…In developing countries, treatment with the oral combination doxycycline/rifampicin is preferred because of its convenience. 23 Our patient was treated with doxycycline and rifampin after surgery to prevent relapse.…”

Section: Discussionmentioning

confidence: 98%

“…The relapse rate of brucellosis was 6.6% until 9 months after starting the treatment; Therefore, treatment failure and relapse are major problems in the management of brucellosis. In developing countries, treatment with the oral combination doxycycline/rifampicin is preferred because of its convenience 23 . Our patient was treated with doxycycline and rifampin after surgery to prevent relapse.…”

Section: Discussionmentioning

confidence: 99%

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Massive cardiac vegetation and cardiomyopathy in a 23‐year‐old rancher with brucellosis

Mirhosseini,

Bagheri,

Lak

et al. 2023

Clinical Case Reports

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Key clinical massageA 23‐year‐old rancher was admitted with the diagnosis of brucellosis. In evaluations, a massive vegetation in the aortic valve was seen. A combination of antibiotic therapy and cardiac surgery were performed, it seems this approach reduces mortality and complications.AbstractBrucellosis (also known as “undulant fever,” “Mediterranean fever,” or “Malta fever”) is a zoonotic infection transmitted to humans from infected animals (cattle, sheep, goats, camels, pigs, or other animals) by ingestion of food products (such as unpasteurized dairy products) or by contact with tissue or fluids. It is the most frequent zoonosis globally and a major public health issue in many resource‐poor nations. Endocarditis is one of the rarest and most dangerous consequences of brucellosis. Additionally, the combination of endocarditis with cardiomyopathy increases its rarity. This condition is usually treated with a high level of suspicion Serological, clinical, and epidemiological data can all be used to make a diagnosis. The use of echocardiography aids in the early diagnosis. Due to the high risk of recurrence and the extent of tissue destruction brought on by Brucella, the majority of experts advise an early surgical intervention; nevertheless, other writers assert that low‐risk patients also require cautious therapy. In this article, we discuss the situation of a patient who underwent surgery and had Brucella endocarditis and heart failure. In conclusion, a combination of antibiotic therapy and cardiac surgery, reduces mortality and complications associated with Brucella endocarditis and improves patient quality of life.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Massive cardiac vegetation and cardiomyopathy in a 23‐year‐old rancher with brucellosis

Mirhosseini,

Bagheri,

Lak

et al. 2023

Clinical Case Reports

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“…Chronic, complicated brucellosis cases can need different treatment agents such as tigesiklin, trimethoprim-sulfamethoxazole, or fluoroquinolone [7]. It was emphasized that delayed treatment is associated with high relapse rates and treatment failure [8]. Magnetic resonance imaging is recommended to see the disease's extent and evaluate the effectiveness of treatment.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Arthritis and Tenosynovitis in a Patient With Brucellosis

Elmas¹,

Ulutaş²

2023

Cureus

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Brucellosis is an infectious disease caused by Gram-negative bacteria. Musculoskeletal system involvement is common in patients with brucellosis. Herein we report a patient who presented with bilateral arthralgia in the ankles and diffuse swelling of the left hand in the follow-up. He had been diagnosed with brucellosis and improved well after a 10-week duration of antibiotic therapy. Rheumatic diseases may have many infectious mimickers. Brucellosis is one of those that should be considered in the differential diagnosis.

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“…Confirming brucellosis requires a combination of exposure history, clinical manifestations, and specific laboratory tests. Underdiagnosis of brucellosis leads to higher rates of complicated cases [ 9 ]. Focal involvement in brucellosis requires longer treatment duration and additional antimicrobial agents compared to uncomplicated cases [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China

Shi,

Qin,

et al. 2024

Infect Dis Poverty

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Background Brucellosis is a severe zoonotic disease that is often overlooked, particularly in impoverished countries. Timely identification of focal complications in brucellosis is crucial for improving treatment outcomes. However, there is currently a lack of established indicators or biomarkers for diagnosing these complications. Therefore, this study aimed to investigate potential warning signs of focal complications in human brucellosis, with the goal of providing practical parameters for clinicians to aid in the diagnosis and management of patients. Methods A multi-center cross-sectional study was conducted in China from December 2019 to August 2021. The study aimed to investigate the clinical characteristics and complications of patients with brucellosis using a questionnaire survey and medical record system. The presence of warning signs for complications was assessed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used for variable screening and model evaluation. Results A total of 880 participants diagnosed with human brucellosis were enrolled. The median age of the patients was 50 years [interquartile range (IQR): 41.5–58.0], and 54.8% had complications. The most common organ system affected by complications was the osteoarticular system (43.1%), with peripheral arthritis (30.0%), spondylitis (16.6%), paravertebral abscess (5.0%), and sacroiliitis (2.7%) being the most prevalent. Complications in other organ systems included the genitourinary system (4.7%), respiratory system (4.7%), and hematologic system (4.6%). Several factors were found to be associated with focal brucellosis. These factors included a long delay in diagnosis [odds ratio (OR) = 3.963, 95% confidence interval (CI) 1.906–8.238 for > 90 days], the presence of underlying disease (OR = 1.675, 95% CI 1.176–2.384), arthralgia (OR = 3.197, 95% CI 1.986–5.148), eye bulging pain (OR = 3.482, 95% CI 1.349–8.988), C-reactive protein (CRP) > 10 mg/L (OR = 1.910, 95% CI 1.310–2.784) and erythrocyte sedimentation rate (ESR) elevation (OR = 1.663, 95% CI 1.145–2.415). The optimal cutoff value in ROC analysis was > 5.4 mg/L for CRP (sensitivity 73.4% and specificity 51.9%) and > 25 mm/h for ESR (sensitivity 47.9% and specificity 71.1%). Conclusions More than 50% of patients with brucellosis experienced complications. Factors such as diagnostic delay, underlying disease, arthralgia, eye pain, and elevated levels of CRP and ESR were identified as significant markers for the development of complications. Therefore, patients presenting with these conditions should be closely monitored for potential complications, regardless of their culture results and standard tube agglutination test titers.

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Epidemiological features of brucellosis and factors affecting its treatment failure and relapse in Qom Province, Iran

Cited by 5 publications

References 13 publications

Massive cardiac vegetation and cardiomyopathy in a 23‐year‐old rancher with brucellosis

Massive cardiac vegetation and cardiomyopathy in a 23‐year‐old rancher with brucellosis

Peripheral Arthritis and Tenosynovitis in a Patient With Brucellosis

Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China

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