scholarly journals Congenital brucellosis: a case report

2021 ◽  
Author(s):  
Dan XU ◽  
Xuejing Li ◽  
Beilei Cheng ◽  
Yunlian Zhou ◽  
Mingming Zhou ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Brucella Melitensis ◽  
Human Brucellosis ◽  
Bacterial Identification ◽  
Disease Relapse ◽  
Zoonotic Infection ◽  
Case Presentation ◽  
Membrane Rupture ◽  
Drug Choice ◽  
Generation Sequencing

Abstract Background Brucellosis is the most common zoonotic infection worldwide, and is caused by bacterial genus Brucella. The disease is rarely transmitted via human-to-human transmission. Few cases have been reported about vertical transmission of human brucellosis. Herein, we reported a case of congenital brucellosis, with clear evidence of pathogen detected in mother’s placental specimen. Case presentation: A 34-day-old girl was admitted to the department of pulmonology with fever for eight days. Three blood samples and one sample of cerebrospinal fluid were positive for Brucella melitensis. The diagnosis of brucellosis and Brucella melitensis meningitis were established, along with hyperbilirubinemia and liver dysfunction. Treatment of rifampicin (for six weeks) and meropenem (for two weeks) was administered. However, the disease relapsed within 18 days. Thereafter, a combination therapy of rifampicin and SMZ/TMP was administered for eight weeks. The disease relapsed again in 42 days. For chronic brucellosis, three courses of combination therapy of rifampicin and SMZ/TMP was administered. The mother had fatigue and arthralgia for two weeks, fever and membrane rupture one day before the baby was born. Brucella melitensis DNA was detected in the mother’s placental specimen by next-generation sequencing and bacterial identification under microscope proved chorioamnionitis. Conclusions We reported a confirmed case of congenital brucellosis. This disease should be closely monitored even in non-epidemic areas. The treatment of brucellosis in infancy faces challenges of drug choice and disease relapse.

scholarly journals A Congenital Brucellosis Case of 34-day-old Girl

2021 ◽  
Author(s):  
Dan Xu ◽  
Xuejing Li ◽  
Beilei Cheng ◽  
Yunlian Zhou ◽  
Mingming Zhou ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Human Brucellosis ◽  
Disease Relapse ◽  
Limited Data ◽  
Zoonotic Infection ◽  
Case Presentation ◽  
Blood Samples ◽  
Membrane Rupture ◽  
The World ◽  
Generation Sequencing

Abstract Background: Brucellosis is the most common zoonotic infection over the world, caused by bacterial genus brucella. The disease is transmitted rarely via human-to-human transmission. Limited data support vertical transmission of human brucellosis. Herein, we reported a case of congenital brucellosis case with solid evidence of pathogen detected in mother’s placental specimen.Case presentation: A 34-day-old girl was admitted to department of pulmonology because of fever for eight days. Her mother had fatigue and arthralgia for 2 weeks, fever and membrane rupture 1 day before the baby was born. Three blood samples and one sample of cerebrospinal fluid showed positive with Brucella meliteusis. The diagnosis of brucellosis and Brucella meliteusis meningitis were established with hyperbilirubinemia and liver dysfunction. Treatment of rifampicin (6 weeks) and meropenem (2 weeks) was applied. However, the disease relapsed 3 weeks. A combination therapy of rifampicin and SMZ/TMP lasted for eight weeks. Brucella meliteusis DNA was detected by next-generation sequencing and bacterial identifying under microscope in mother’s placental specimen, which also proved chorioamnionitis. The baby was still in following-up.Conclusions: We reported a confirmed case of congenital brucellosis. This disease should be paid enough attention even in non epidemic areas. The treatment of brucellosis in infancy face the challenge of medicine choosing and disease relapse.

scholarly journals Human brucellosis in a non-susceptible host: a case report

2018 ◽  
Vol 5 (4) ◽  
pp. 1072
Author(s):  
Yoganathan Chidambaram ◽  
Murali Alagesan ◽  
Clement Jenil Dhas
Keyword(s):  
Brucella Melitensis ◽  
Human Brucellosis ◽  
Zoonotic Infection ◽  
Susceptible Host ◽  
Health Care Practitioners ◽  
Unpasteurized Milk ◽  
Loss Of Weight ◽  
Common Causes ◽  
History Of ◽  
Loss Of Appetite

Clinical human brucellosis is quite rare in India, that too in an non susceptible host. This report describes a case of clinical human brucellosis in India. This case involved a 36 years old male, a professor in an Engineering college. He presented with complaints of fever for 4 months with myalgia, generalized tiredness, loss of weight and loss of appetite. On evaluation, total counts and ESR was elevated and all other investigations were normal. Based on history, common causes like occult tuberculosis or autoimmune diseases were considered. But, blood cultures grew Brucella melitensis in all 2 samples and a diagnosis of brucellosis was made. He was treated with Rifampicin and Doxycycline. Suspicion of brucellosis in this patient is low because the patient has no history of contact with animals, consumption of unpasteurized milk or occupational exposure. So, the health care practitioners should be aware of this possibility of this zoonotic infection as a differential diagnosis in patients with nonspecific symptoms and unexplained prolonged fever.

scholarly journals Molecular characteristics of Brucella melitensis isolates from humans in Qinghai Province, China

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhi-Jun Zhao ◽  
Ji-Quan Li ◽  
Li Ma ◽  
Hong-Mei Xue ◽  
Xu-Xin Yang ◽  
...  
Keyword(s):  
Tandem Repeats ◽  
Brucella Melitensis ◽  
Draft Genome ◽  
Geographic Origin ◽  
Variable Number ◽  
Human Brucellosis ◽  
Molecular Characteristics ◽  
Whole Genome ◽  
Qinghai Province ◽  
Variable Number Tandem Repeats

Abstract Background The prevalence of human brucellosis in Qinghai Province of China has been increasing rapidly, with confirmed cases distributed across 31 counties. However, the epidemiology of brucellosis transmission has not been fully elucidated. To characterize the infecting strains isolated from humans, multiple-locus variable-number tandem repeats analysis (MLVA) and whole-genome single-nucleotide polymorphism (SNP)-based approaches were employed. Methods Strains were isolated from two males blood cultures that were confirmed Brucella melitensis positive following biotyping and MLVA. Genomic DNA was extracted from these two strains, and whole-genome sequencing was performed. Next, SNP-based phylogenetic analysis was performed to compare the two strains to 94 B. melitensis strains (complete genome and draft genome) retrieved from online databases. Results The two Brucella isolates were identified as B. melitensis biovar 3 (QH2019001 and QH2019005) following conventional biotyping and were found to have differences in their variable number tandem repeats (VNTRs) using MLVA-16. Phylogenetic examination assigned the 96 strains to five genotype groups, with QH2019001 and QH2019005 assigned to the same group, but different subgroups. Moreover, the QH2019005 strain was assigned to a new subgenotype, IIj, within genotype II. These findings were then combined to determine the geographic origin of the two Brucella strains. Conclusions Utilizing a whole-genome SNP-based approach enabled differences between the two B. melitensis strains to be more clearly resolved, and facilitated the elucidation of their different evolutionary histories. This approach also revealed that QH2019005 is a member of a new subgenotype (IIj) with an ancient origin in the eastern Mediterranean Sea.

scholarly journals Severe pneumonia caused by Parvimonas micra: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Yu ◽  
Lingling Sun ◽  
Zuqing Xu ◽  
Lumei Fan ◽  
Yunbo Du
Keyword(s):  
Bronchoalveolar Lavage Fluid ◽  
Case Reports ◽  
Severe Pneumonia ◽  
Lavage Fluid ◽  
Due Date ◽  
Case Presentation ◽  
Abdominal Abscesses ◽  
Parvimonas Micra ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

Abstract Background Parvimonas micra (P. micra) is a gram-positive anaerobic coccus that is detected widely on the skin, in the oral mucosa and in the gastrointestinal tract. In certain circumstances, P. micra can cause abdominal abscesses, bacteraemia and other infections. To the best of our knowledge, there have been no case reports describing the biological characteristics of P. micra-related pneumonia. These bacteria do not always multiply in an aerobic organ, such as the lung, and they could be easily overlooked because of the clinical mindset. Case presentation A 35-year-old pregnant woman was admitted to the emergency department 4 weeks prior to her due date who was exhibiting 5 points on the Glasgow coma scale. A computed tomography (CT) scan showed a massive haemorrhage in her left basal ganglia. She underwent a caesarean section and brain surgery before being admitted to the ICU. She soon developed severe pneumonia and hypoxemia. Given that multiple sputum cultures were negative, the patient’s bronchoalveolar lavage fluid was submitted for next-generation sequencing (NGS) to determine the pathogen responsible for the pneumonia; as a result, P. micra was determined to be the causative pathogen. Accordingly the antibiotic therapy was altered and the pneumonia improved. Conclusion In this case, we demonstrated severe pneumonia caused by the anaerobic organism P. micra, and the patient benefited from receiving the correct antibiotic. NGS was used as a method of quick diagnosis when sputum culture failed to distinguish the pathogen.

scholarly journals Isolation of Mycobacterium talmoniae from a patient with diffuse panbronchiolitis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomoko Suzuki ◽  
Miwako Saitou ◽  
Yuriko Igarashi ◽  
Satoshi Mitarai ◽  
Katsunao Niitsuma
Keyword(s):  
Combination Therapy ◽  
Bronchoalveolar Lavage Fluid ◽  
Left Lung ◽  
Lavage Fluid ◽  
Drug Susceptibility ◽  
Acid Fast Bacillus ◽  
Case Presentation ◽  
Diffuse Panbronchiolitis ◽  
Potential Pathogen ◽  
Culture Positive

Abstract Background Mycobacterium (M) talmoniae isolated from a patient with cystic fibrosis was first described in 2017, and cases of M. talmoniae remain exceedingly rare. Case presentation A 51-year-old woman had respiratory symptoms for 10 years. Diffuse panbronchiolitis (DPB) was detected at the first visit at our hospital. A cavity lesion in the apex of the left lung was found, and sputum and bronchoalveolar lavage fluid were acid-fast bacillus (AFB) smear- and culture-positive besides Pseudomonas aeruginosa. M. talmoniae was finally identified, and the standard combination therapy for non-tuberculous mycobacteria (NTM) was administered for 2 y referring to the drug-susceptibility test. Thereafter, the AFB culture was negative, the wall thickness of the lung cavity was ameliorated, and oxygen saturation improved. Conclusions We encountered a rare case of M. talmoniae with DPB, for which standard combination therapy was effective. M. talmoniae may be considered a potential pathogen of lung disease, especially in patients with bronchiectatic lesions.

Does perianal disease influence the efficacy of combination therapy in Crohn’s disease?

2020 ◽  
Author(s):  
Rui de Sousa Magalhães ◽  
Sofia Xavier ◽  
Tiago Cúrdia Gonçalves ◽  
Francisca Dias de Castro ◽  
Bruno Rosa ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Clinical Remission ◽  
Odds Ratio ◽  
Perianal Disease ◽  
Outcome Variable ◽  
P Value ◽  
Disease Relapse ◽  
Endoscopic Remission ◽  
Remission Rates ◽  
One Year

Background: Perianal disease is associated with a disabling course of CD. We aim to study the impact of perianal disease on CD remission rates, after a one-year course of infliximab in combination therapy with azathioprine. Methods: Cohort, retrospective, single centre study, including consecutive CD patients on combination therapy, followed for one year since induction. The outcome variable was split into clinical and endoscopic remission. The correlation towards the outcome variable was assessed with univariate and multivariate analysis, and a survival assessment, using SPSS software. Results: We assessed 74 CD patients, of whom 41 (55.4%) were female, with a mean age of 36 years-old. Thirty-nine percent of the patients presented perianal disease at diagnosis (n=29). We documented 70.3% clinical and 47.2% endoscopic remissions. Several variables had statistical significance towards the outcomes (endoscopic and clinical remission) in the univariate analysis. After adjusting for confoundment, patients with perianal disease presented an odds ratio of 0.20 for achieving endoscopic remission (odds ratio 0.201 CI [0.054-0.75] p-value 0.017) and an odds ratio of 0.203 for achieving clinical remission (OR 0.203 CI [0.048-0.862] p-value 0.031). Sixty-six patients (89.2%) presented an initial response to treatment, from whom, 20 (30.3%) exhibited at least one disease relapse (clinical and/or endoscopic). Patients with perianal disease presented higher probability of disease relapse, displaying statistically significant difference on Kaplan-Meyer curves (Breslow p-value 0.043). Conclusion: In the first year of combination therapy, perianal disease is associated with an 80% decrease in endoscopic and clinical remission rates and higher ratio of disease relapse.

scholarly journals The First Livebirth Using Warmed Oocytes by a Semi-Automated Vitrification Procedure

2020 ◽  
Author(s):  
Xavier Orriols Brunetti ◽  
Suzanne Cawood ◽  
Matthew Gaunt ◽  
Wael Saab ◽  
Paul Serhal ◽  
...  
Keyword(s):  
Blastocyst Stage ◽  
Frozen Embryo Transfer ◽  
Automated System ◽  
Standard Laboratory ◽  
Laboratory Procedure ◽  
Case Presentation ◽  
Laboratory Procedures ◽  
Donor Oocytes ◽  
Generation Sequencing ◽  
Laboratory Time

Background: The first successful livebirth using warmed oocytes (vitrified by the GAVITM system) is reported in this paper. Embryologists throughout the world have vitrified oocytes using a manual technique which is susceptible to error and variation. In this era of automated laboratory procedures, vitrification was made semi-automatic by using the GAVITM system. Case Presentation: Donor oocytes were initially vitrified using the GAVITM system. They remained in the clinic’s oocyte bank until they were allocated to the patient. Donor oocytes were warmed as per Genea BIOMEDX protocol and inseminated to create embryos. Resulting embryos for the 42-year-old patient were cultured to the blastocyst stage, biopsied to perform PGT-A, using next generation sequencing and subsequently vitrified. The patient underwent a single euploid transfer in a frozen embryo transfer cycle which resulted in a healthy livebirth. Conclusion: The introduction of a semi-automated system should minimize the risk to the oocytes, standardize the procedure worldwide and potentially reduce the laboratory time taken by the embryologists. This case report demonstrates the safety of the technology used for vitrification, but larger randomized studies need to be performed to demonstrate the safety and efficacy of newer technologies like the GAVITM system before adopting it as a standard laboratory procedure.

scholarly journals Veno-venous extracorporeal membrane oxygenation successfully treated a case of severe pulmonary hemorrhage caused by leptospirosis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
H. J. Wang ◽  
G. Z. Chen ◽  
C. J. Zhou ◽  
Y. FU ◽  
L. N. YAO
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Mainland China ◽  
Pulmonary Hemorrhage ◽  
Lavage Fluid ◽  
Case Presentation ◽  
Membrane Oxygenation ◽  
Second Generation Sequencing ◽  
Very High ◽  
Generation Sequencing ◽  
Secondary Condition

Abstract Background Pulmonary hemorrhage is an important complication of leptospirosis. Once acute respiratory distress syndrome (ARDS) occurs as a secondary condition, treatment is extremely difficult and the mortality rate is very high. Case presentation The patient was a 49-year-old. He was admitted to the hospital because he had experienced a fever and cough for 4 days. Hemorrhage, respiratory failure, ARDS and other symptoms appeared soon after admission. Due to severe pulmonary hemorrhage secondary to ARDS, mechanical ventilation was performed through tracheal intubation. During intubation, the patient suffered cardiac arrest, and the patient’s condition worsened. He was confirmed to have leptospirosis through second-generation sequencing of the alveolar lavage fluid. Finally, we successfully treated the patient with penicillin as an anti-infective medication and venous-venous extracorporeal membrane oxygenation (v-vECMO). To the best of our knowledge, this report is the first to describe the successful application of ECMO in mainland China. Conclusions Leptospirosis can induce serious but transient ARDS with a better prognosis than other causes of ARDS. Our patient was successfully treated with V-vECMO.

scholarly journals Effect of combination therapy with ceftizoxime and clotrimazole in the treatment of otomycosis

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Saeid Mahdavi Omran ◽  
Zahra Yousefzade ◽  
Soraya Khafri ◽  
Mojtaba Taghizadeh-Armaki ◽  
Keyvan Kiakojuri
Keyword(s):  
Combination Therapy ◽  
Tympanic Membrane ◽  
Direct Observation ◽  
Fungal Infections ◽  
Intervention Group ◽  
Tympanic Membrane Perforation ◽  
Antifungal Drugs ◽  
Common Finding ◽  
Control Group ◽  
Membrane Rupture

  Background and Purpose: There are controversial findings regarding the efficacy of antifungal drugs in the treatment of a ruptured eardrum following fungal infections. Regarding this, the aim of the present study was to evaluate the therapeutic effect of the co-administration of antifungal and antibacterial agents in the treatment of otomycosis with tympanic membrane perforation. Materials and Methods: This analytical, clinical trial was conducted on 87 patients with otomycosis showing no bacterial elements in the direct observation and culture. The study population was assigned into two groups of intervention (n=45) and control (n=42). The demographic and clinical data, as well as the data related to the direct observation and culture of the ear samples were recorded in a checklist. All statistical analysis was performed in SPSS (version 24). Results: The most prevalent symptoms in both groups were hearing loss and itching, and the most common finding was secretion. Aspergillus and Candida were the most frequent fungi isolated from the samples. After the implementation of combination therapy, the intervention group demonstrated a significant decrease in symptoms and signs, compared to the control group (P=0.005). Conclusion: The findings of the present study indicated that the use combination therapy with ceftizoxime powder and clotrimazole ointment was effective the in treatment of the patients with tympanic membrane rupture showing no bacterial effects in direct examination and culture.

Sign in / Sign up

Export Citation Format

Share Document