Chronic Brucellosis in Japan

Human brucellosis, one of the most common zoonoses worldwide, rarely occurs in Japan, and only a few chronic cases have been reported. We herein report the case of a 39-year-old Japanese woman with chronic human brucellosis, considered a Brucella canis infection, that persisted for 19 years. Her med...

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Published inInternal Medicine Vol. 58; no. 21; pp. 3179 - 3183
Main Authors Kawakami, Naoki, Wakai, Yoko, Saito, Kazuhito, Imaoka, Koichi
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.11.2019
Japan Science and Technology Agency
Subjects
Administration, Oral
Adult
Agglutination
Animals
Anti-Bacterial Agents - administration & dosage
Brucella canis
Brucellosis
Brucellosis - diagnosis
Brucellosis - drug therapy
Case Report
chronic brucellosis
Chronic Disease
chronic fatigue
Chronic infection
Diagnosis, Differential
Differential diagnosis
Doxycycline
Doxycycline - administration & dosage
Drug Therapy, Combination
Fatigue - diagnosis
Fatigue - microbiology
Female
Fever
Fever - diagnosis
Fever - microbiology
Humans
Injections, Intramuscular
intermittent fever
Internal medicine
Japan
Streptomycin
Streptomycin - administration & dosage
undulant fever
Zoonoses
Zoonoses - diagnosis
Zoonoses - drug therapy
Japan
undulant fever
chronic fatigue
Brucella canis
intermittent fever
chronic brucellosis
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Abstract Human brucellosis, one of the most common zoonoses worldwide, rarely occurs in Japan, and only a few chronic cases have been reported. We herein report the case of a 39-year-old Japanese woman with chronic human brucellosis, considered a Brucella canis infection, that persisted for 19 years. Her medical history and fever pattern suggested chronic brucellosis, and the diagnosis was made based on the results of a serum tube agglutination test (SAT). After undergoing combination therapy with streptomycin and doxycycline, she achieved symptomatic relief and showed negative SAT results. Even in non-endemic areas, chronic brucellosis is an important differential diagnosis in patients with long-term persistent fatigue or a fever.
AbstractList Human brucellosis, one of the most common zoonoses worldwide, rarely occurs in Japan, and only a few chronic cases have been reported. We herein report the case of a 39-year-old Japanese woman with chronic human brucellosis, considered a Brucella canis infection, that persisted for 19 years. Her medical history and fever pattern suggested chronic brucellosis, and the diagnosis was made based on the results of a serum tube agglutination test (SAT). After undergoing combination therapy with streptomycin and doxycycline, she achieved symptomatic relief and showed negative SAT results. Even in non-endemic areas, chronic brucellosis is an important differential diagnosis in patients with long-term persistent fatigue or a fever.
Human brucellosis, one of the most common zoonoses worldwide, rarely occurs in Japan, and only a few chronic cases have been reported. We herein report the case of a 39-year-old Japanese woman with chronic human brucellosis, considered a Brucella canis infection, that persisted for 19 years. Her medical history and fever pattern suggested chronic brucellosis, and the diagnosis was made based on the results of a serum tube agglutination test (SAT). After undergoing combination therapy with streptomycin and doxycycline, she achieved symptomatic relief and showed negative SAT results. Even in non-endemic areas, chronic brucellosis is an important differential diagnosis in patients with long-term persistent fatigue or a fever.Human brucellosis, one of the most common zoonoses worldwide, rarely occurs in Japan, and only a few chronic cases have been reported. We herein report the case of a 39-year-old Japanese woman with chronic human brucellosis, considered a Brucella canis infection, that persisted for 19 years. Her medical history and fever pattern suggested chronic brucellosis, and the diagnosis was made based on the results of a serum tube agglutination test (SAT). After undergoing combination therapy with streptomycin and doxycycline, she achieved symptomatic relief and showed negative SAT results. Even in non-endemic areas, chronic brucellosis is an important differential diagnosis in patients with long-term persistent fatigue or a fever.
Human brucellosis, one of the most common zoonoses worldwide, rarely occurs in Japan, and only a few chronic cases have been reported. We herein report the case of a 39-year-old Japanese woman with chronic human brucellosis, considered a Brucella canis infection, that persisted for 19 years. Her medical history and fever pattern suggested chronic brucellosis, and the diagnosis was made based on the results of a serum tube agglutination test (SAT). After undergoing combination therapy with streptomycin and doxycycline, she achieved symptomatic relief and showed negative SAT results. Even in non-endemic areas, chronic brucellosis is an important differential diagnosis in patients with long-term persistent fatigue or a fever.
Author Saito, Kazuhito
Kawakami, Naoki
Wakai, Yoko
Imaoka, Koichi
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Cites_doi 10.1016/j.ijantimicag.2010.06.014
10.1111/zph.12102
10.12935/jvma.64.559
10.1128/JCM.00010-06
10.3855/jidc.2453
10.1016/j.ijid.2011.12.011
10.1136/oem.30.4.385
10.1016/S1473-3099(07)70286-4
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Issue 21
Keywords undulant fever
chronic fatigue
Brucella canis
intermittent fever
chronic brucellosis
Language English
License The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Correspondence to Dr.　Naoki Kawakami, knaoki0321@hotmail.co.jp
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References 18. Araj GF. Update on laboratory diagnosis of human brucellosis. Int J Antimicrob Agents 36S: S12-S17, 2010.
9. Yumuk Z, O'Callaghan D. Brucellosis in Turkey - an overview. Int J Infect Dis 16: e228-e235, 2012.
17. Imanaka K, Kobayashi I. Spinal brucellosis. Geka no Ryouiki 2: 293-298, 1954 (in Japanese).
4. Tachibana M, Kobayashi N, Inokuma H, Suzuki H, Watarai M. Seroepidemiological survey of Brucella canis infection in dogs in Japan using the tube agglutination test. J Jpn Vet Med Assoc 64: 559-561, 2011.
16. Nao Y, Tachi T. Clinical experience of brucellosis. Rinshou Naika Shounika 5: 72-75, 1950 (in Japanese).
13. Nishikawa J. A case of Bang's disease in Japan. Tokyo Iji Shinshi 2843: 23-24, 1933 (in Japanese).
14. Nakagawa H. A case of Bang's disease. Jikken Ihou 20: 907-911, 1934 (in Japanese).
20. Mitka S, Anetakis C, Souliou E, Diza E, Kansouzidou A. Evaluation of different PCR assays for early detection of acute and relapsing brucellosis in humans in comparison with conventional methods. J Clin Microbiol 45: 1211-1218, 2007.
2. Imaoka K. Review: Brucellosis. JBSA Newsletter vol. 17, No. 1, 2018 May (in Japanese) [Internet]. [cited 2019 Feb 10]. Available from: https://www.microbiology.co.jp/jbsa/information/2017/newsletter_vol7_1.pdf
10. Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 132: 98-105, 2002.
5. Krueger WS, Lucero NE, Brower A, Heil GL, Gray GC. Evidence for unapparent Brucella canis infections among adults with occupational exposure to dogs. Zoonoses Public Health 61: 509-518, 2014.
21. Alsayed Y, Monem F. Brucellosis laboratory tests in Syria: what are their diagnostic efficacies in different clinical manifestations? J Infect Dev Ctries 6: 495-500, 2012.
12. Ahmed W, Zheng K, Liu ZF. Establishment of chronic infection: Brucella's stealth strategy. Front Cell Infect Microbiol 6: 30, 2016.
6. Scarlett EP. Chronic brucellosis; diagnosis and treatment. Can Med Assoc J 58: 230-235, 1948.
8. Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis 7: 775-786, 2007.
22. Erdem H, Ulu-Kilic A, Kilic S, et al. Efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the Istanbul study. Antimicrob Agents Chemother 56: 1523-1528, 2012.
15. Kakinuma K, Yamakawa K. Brucellosis. Jikken Ihou 28: 661-665, 1941 (in Japanese).
7. McDevitt DG. Symptomatology of chronic brucellosis. Br J Ind Med 30: 385-389, 1973.
19. Galińska EM, Zagorski J. Brucellosis in humans - etiology, diagnostics, clinical forms. Ann Agric Environ Med 20: 233-238, 2013.
1. World Health Organization. The Special Programme for Research and Training in Tropical Diseases (TDR) 2012. Research priorities for zoonoses and marginalized infections [Internet]. [cited 2019 Feb 1]. Available from: http://www.who.int/tdr/publications/zoonoses/en
3. WHO/CDS/EPR/2006.7. Brucellosis in humans and animals [Internet]. [cited 2019 Feb 3]. Available from: http://www.who.int/csr/resources/publications/deliberate/WHO_CDS_EPR_2006_7/en
11. Griggs JF. Chronic brucellosis: diagnostic points noted in one hundred cases. Cal West Med 58: 118-125, 1943.
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18
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References_xml – reference: 17. Imanaka K, Kobayashi I. Spinal brucellosis. Geka no Ryouiki 2: 293-298, 1954 (in Japanese).
– reference: 12. Ahmed W, Zheng K, Liu ZF. Establishment of chronic infection: Brucella's stealth strategy. Front Cell Infect Microbiol 6: 30, 2016.
– reference: 13. Nishikawa J. A case of Bang's disease in Japan. Tokyo Iji Shinshi 2843: 23-24, 1933 (in Japanese).
– reference: 15. Kakinuma K, Yamakawa K. Brucellosis. Jikken Ihou 28: 661-665, 1941 (in Japanese).
– reference: 18. Araj GF. Update on laboratory diagnosis of human brucellosis. Int J Antimicrob Agents 36S: S12-S17, 2010.
– reference: 9. Yumuk Z, O'Callaghan D. Brucellosis in Turkey - an overview. Int J Infect Dis 16: e228-e235, 2012.
– reference: 3. WHO/CDS/EPR/2006.7. Brucellosis in humans and animals [Internet]. [cited 2019 Feb 3]. Available from: http://www.who.int/csr/resources/publications/deliberate/WHO_CDS_EPR_2006_7/en/
– reference: 5. Krueger WS, Lucero NE, Brower A, Heil GL, Gray GC. Evidence for unapparent Brucella canis infections among adults with occupational exposure to dogs. Zoonoses Public Health 61: 509-518, 2014.
– reference: 22. Erdem H, Ulu-Kilic A, Kilic S, et al. Efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the Istanbul study. Antimicrob Agents Chemother 56: 1523-1528, 2012.
– reference: 20. Mitka S, Anetakis C, Souliou E, Diza E, Kansouzidou A. Evaluation of different PCR assays for early detection of acute and relapsing brucellosis in humans in comparison with conventional methods. J Clin Microbiol 45: 1211-1218, 2007.
– reference: 21. Alsayed Y, Monem F. Brucellosis laboratory tests in Syria: what are their diagnostic efficacies in different clinical manifestations? J Infect Dev Ctries 6: 495-500, 2012.
– reference: 10. Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 132: 98-105, 2002.
– reference: 7. McDevitt DG. Symptomatology of chronic brucellosis. Br J Ind Med 30: 385-389, 1973.
– reference: 8. Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis 7: 775-786, 2007.
– reference: 14. Nakagawa H. A case of Bang's disease. Jikken Ihou 20: 907-911, 1934 (in Japanese).
– reference: 1. World Health Organization. The Special Programme for Research and Training in Tropical Diseases (TDR) 2012. Research priorities for zoonoses and marginalized infections [Internet]. [cited 2019 Feb 1]. Available from: http://www.who.int/tdr/publications/zoonoses/en/
– reference: 11. Griggs JF. Chronic brucellosis: diagnostic points noted in one hundred cases. Cal West Med 58: 118-125, 1943.
– reference: 16. Nao Y, Tachi T. Clinical experience of brucellosis. Rinshou Naika Shounika 5: 72-75, 1950 (in Japanese).
– reference: 2. Imaoka K. Review: Brucellosis. JBSA Newsletter vol. 17, No. 1, 2018 May (in Japanese) [Internet]. [cited 2019 Feb 10]. Available from: https://www.microbiology.co.jp/jbsa/information/2017/newsletter_vol7_1.pdf
– reference: 19. Galińska EM, Zagorski J. Brucellosis in humans - etiology, diagnostics, clinical forms. Ann Agric Environ Med 20: 233-238, 2013.
– reference: 4. Tachibana M, Kobayashi N, Inokuma H, Suzuki H, Watarai M. Seroepidemiological survey of Brucella canis infection in dogs in Japan using the tube agglutination test. J Jpn Vet Med Assoc 64: 559-561, 2011.
– reference: 6. Scarlett EP. Chronic brucellosis; diagnosis and treatment. Can Med Assoc J 58: 230-235, 1948.
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Snippet Human brucellosis, one of the most common zoonoses worldwide, rarely occurs in Japan, and only a few chronic cases have been reported. We herein report the...
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SubjectTerms Administration, Oral
Adult
Agglutination
Animals
Anti-Bacterial Agents - administration & dosage
Brucella canis
Brucellosis
Brucellosis - diagnosis
Brucellosis - drug therapy
Case Report
chronic brucellosis
Chronic Disease
chronic fatigue
Chronic infection
Diagnosis, Differential
Differential diagnosis
Doxycycline
Doxycycline - administration & dosage
Drug Therapy, Combination
Fatigue - diagnosis
Fatigue - microbiology
Female
Fever
Fever - diagnosis
Fever - microbiology
Humans
Injections, Intramuscular
intermittent fever
Internal medicine
Japan
Streptomycin
Streptomycin - administration & dosage
undulant fever
Zoonoses
Zoonoses - diagnosis
Zoonoses - drug therapy
Title Chronic Brucellosis in Japan
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