Acute brucellosis presenting as fever of unknown origin (FUO)
| Autor: | G. I. Higashi, W. Yassin, Raymond H. Watten, B. Trabolsi, Zoheir Farid |
|---|---|
| Rok vydání: | 1980 |
| Předmět: |
Adult
Lung Diseases Male medicine.medical_specialty Tuberculosis Adolescent Brucella Fever of Unknown Origin Brucellosis Internal medicine medicine Humans Blood culture Fever of unknown origin biology medicine.diagnostic_test business.industry Public Health Environmental and Occupational Health Endocarditis Bacterial General Medicine Middle Aged Tetracycline medicine.disease biology.organism_classification Infectious Diseases Streptomycin Erythrocyte sedimentation rate Acute Disease Immunology Female Spinal Diseases Parasitology business Brucella melitensis medicine.drug |
| Zdroj: | Transactions of the Royal Society of Tropical Medicine and Hygiene. 74:402-404 |
| ISSN: | 0035-9203 |
| DOI: | 10.1016/0035-9203(80)90112-1 |
| Popis: | Brucellosis ranks after salmonellosis and tuberculosis as the most important systemic infection causing fever of unknown origin (FUO) in Cairo (HASSAN &%ARID, 1974). The cause is nearly always Brucella melitensis (see PFISCHNER et al., 1957) but owing to the widespread indiscriminate-use of antibiotics in Egypt (FARID et al., 1975), it has become difficult to isolate the organism by blood culture and thus establish a definitive diagnosis. We summarize the clinical data of 16 patients with acute brucellosis presenting with FUO between January 1971 and December 1977 and describe serious complications that developed in three. Patients’-ages ranged from 15 to 54 years (median 38.5’1: four were women and 12 men. Three were farmers constantly in contact with cattle; the others lived in Cairo and presumably acquired the infection through drinking raw milk. All were seriously ill and reported recurrent attacks of fever with generalized arthralgia and profuse sweating of at least one month duration (range one to 24; median 4.5). All except three had been treated with many antibiotics; 10 with chloramphenicol. All except two (who had positive blood cultures for Br. melitensis) had elevated agglutination titres (range 1: 640 to 1: 5120) denoting an acute infection. Br. melitensis was isolated from blood or bone marrow of 13 patients and Br. abortus from one. In the two patients with negative blood cultures the Brucella agglutinations were highly positive. In all but two patients, the total leucocyte count was below 10,000/mm3 (range 3,000 to 13,000; median 5,400). The erythrocyte sedimentation rate (ESR) was elevated in all patients (range 16 to 55mmhr; median 46, Wintrobe method), again denoting an acute process. Of the 16 patients, three developed severe complications; all the others responded to treatment with tetracycline and streptomycin and were cured. Oral tetracycline was given in a dose of two grams daily and streptomycin in a dose of one gram intramuscularly daily; both drugs were given for a minimum of three weeks (FARID et al., 1961). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|