Neurobrucellosis with thalamic infarction: a case report

Tissue infarction secondary to brucellosis: a systematic review of case reports and case series

BACKGROUND

Tissue infarction is a rare but serious life-threatening complication of brucellosis. In this systematic review, we investigated manifestations, diagnostic and therapeutic measures, and causes of tissue infarction in patients with brucellosis.

METHODS

Pubmed/Medline, Embase, Scopus, and Web of Science were systematically searched for case reports or case series that detail tissue infarction secondary to brucellosis up to October 20, 2024. Baseline characteristics, clinical and paraclinical findings, infarcted tissue details, treatments, and outcomes of the patients were independently extracted by two reviewers.

RESULTS

A total of 34 articles were included, reporting on 36 brucellosis patients with tissue infarction in the central nervous system (CNS) (n = 24), spleen (n = 6), heart (n = 3), kidney (n = 1), bowel (n = 1), and three organs-spleen-bowel-kidney- (n = 1). These patients primarily presented with flu-like symptoms and organ-specific manifestations resulting from tissue infarction. Laboratory findings were predominantly suggestive of brucellosis. Furthermore, tissue infarctions were confirmed by imaging in all cases. Most patients indicated improvement with medications and surgical interventions.

CONCLUSION

Tissue infarction in patients with brucellosis can impact various organs, particularly the brain, spleen, and heart, with symptoms differing based on the specific organ involved. As patients with brucellosis exhibit symptoms of tissue infarction, healthcare providers should be aware of this complication. Prompt diagnosis can be achieved through laboratory and imaging investigations. Appropriate medical and surgical treatments should be provided for these cases.

TRIAL REGISTRATION

The study protocol was registered in the international prospective registry of systematic reviews known as PROSPERO (Protocol number: CRD42024595263).

Imported brucellosis: A case series and literature review

BACKGROUND

Brucellosis is one of the main neglected zoonotic diseases. Several factors may contribute to the epidemiology of brucellosis. Imported cases, mainly in travellers but also in recently arrived immigrants, and cases associated with imported products, appear to be infrequently reported.

METHODS

Cases of brucellosis diagnosed at a referral unit for imported diseases in Europe were described and a review of the literature on imported cases and cases associated with contaminated imported products was performed.

RESULTS

Most imported cases were associated with traditional risk factors such as travel/consumption of unpasteurized dairy products in endemic countries. Cases associated with importation of food products or infected animals also occurred. Although a lower disease incidence of brucellosis has been reported in developed countries, a higher incidence may still occur in specific populations, as illustrated by cases in Hispanic patients in the USA and in Turkish immigrants in Germany. Imported brucellosis appears to present with similar protean manifestations and both classical and infrequent modes of acquisition are described, leading on occasions to mis-diagnoses and diagnostic delays.

CONCLUSIONS

Importation of Brucella spp. especially into non-endemic areas, or areas which have achieved recent control of both animal and human brucellosis, may have public health repercussions and timely recognition is essential.