Neonatal brucellosis: A case report

An Epidemiological Study of Brucellosis in Different Animal Species from the Al-Qassim Region, Saudi Arabia

Brucellosis is a zoonotic bacterial illness that affects humans and a variety of domestic animals, especially ruminants. It is mostly transmitted through the consumption of contaminated drinks, foods, undercooked meat, or unpasteurized milk or contact with infected animals. Therefore, the present study aimed to investigate the seroprevalence of brucellosis in camels, sheep, and goat herds in the Qassim region, Saudi Arabia, using commonly used diagnostic serological procedures such as the Rose Bengal test (RBT), complement fixation test (CFT), and enzyme-linked immunosorbent assay (ELISA). The seroprevalence of brucellosis in camels, sheep, and goats was determined in the selected areas using a cross-sectional study design and a total of 690 farm animals of both sexes of different ages from the three animal species (274 camels, 227 sheep, and 189 goats). According to RBT results, 65 sera were positive for brucellosis, including 15 (5.47%) for camels, 32 (14.09%) for sheep, and 18 (9.50%) for goats. CFT and c-ELISA were performed as confirmatory tests on positive samples resulting from RBT. With c-ELISA, 60 serum samples were confirmed positive, in 14 (5.10%), 30 (13.21%), and 16 (8.46%) camels, sheep, and goats, respectively. There were 59 serum samples confirmed as positive for CFT, including 14 (5.11%), 29 (12.77%), and 16 (8.46%) for camels, sheep, and goats, respectively. Overall, the highest seroprevalence of brucellosis was found in sheep while the least was found in camels from the three tests (RBT, c-ELISA, and CFT). The highest seroprevalence of brucellosis was found in sheep while the least seroprevalence was found in camels. There was also a higher seroprevalence of brucellosis among female animals than males as well as among old animals than young animals. The study, thus, demonstrates brucellosis seroprevalence among farm animals (camels, sheep, and goats) and the significance of intervention measures against brucellosis incidence in both humans and animals through the creation of public awareness and other relevant policy measures such as livestock vaccination, effective hygiene management, and adequate quarantine or serological analysis for newly introduced animals.

Scenario of pathogenesis and socioeconomic burden of human brucellosis in Saudi Arabia

Brucellosis is considered a prevailing endemic infectious disease in the Kingdom of Saudi Arabia and represents a health problem with socio-economic burden. There are two main Brucella species that cause human brucellosis; Brucella abortus, and Brucella melitensis. The clinical features range from asymptomatic to the acute symptoms of fever, joint pain, muscle pain, headache, nausea/vomiting, anorexia and malaise in addition to the subsequent complications that might occur. The endemicity of brucellosis might be explained due to obstacles in controlling the importation of animals for slaughtering during Hajj periods and for several other predisposing factors. The distribution of the disease is all over the country and the most prevalent part is the south followed by north and then the east and central parts. However, in the complexity of brucellosis control measures, there are several activities which have been implemented to tackle the disease such as mass vaccination of animals, regulating importation of slaughter animals, and improving public awareness. This review provides a detailed description of the status of brucellosis in Saudi Arabia, which includes epidemiology, clinical characteristics, virulence and pathophysiology, and prevention of the disease.

Congenital brucellosis: A case report

Although rare, brucellosis is endemic in the Kingdom of Saudi Arabia (KSA). In the case presented here, a neonate was born at 29 weeks gestation with severe respiratory depression, pyrexia; hypotension and an elevated white blood cell count. Her mother was a 19-year-old pregnant woman who developed premature rupture of the membranes and went into labour early. Sepsis was suspected and so the neonate received dobutamine and empiric ampicillin/gentamicin. The mother reported visiting a farm during her pregnancy and so congenital brucellosis was considered a possibility. Blood cultures were positive for Gram-negative coccobacilli and serology confirmed the presence of Brucella abortus and B. meltiness. Antibiotic treatment was changed to rifampin/gentamicin/ciprofloxacin but on day 17 the baby deteriorated and gentamicin was discontinued and meropenem was added. The neonate gradually improved; meropenem was discontinued on day 24 and the baby was discharged from hospital on day 38.

Congenital Brucellosis: A Systematic Review of the Literature

BACKGROUND

Knowledge of the spectrum of presentations and the outcome of congenital brucellosis should expedite diagnosis and improve prognostication.

METHODS

A systematic review of literature of cases of congenital brucellosis was performed on October 10, 2017 (registered as PROSPERO CRD42017072061).

RESULTS

A case seen by the authors was added to the review, yielding 44 reported cases of which 22 (50%) were from Turkey, Saudi Arabia, or Kuwait. For cases with the gestational age reported, 23 of 37 (62%) were preterm. The species was Brucella melitensis in 35 cases, Brucella abortus in 3 cases and not documented in 6 cases. The diagnosis was based on a positive blood culture from the first day of life in 20 cases (45%). Presentation was usually typical for a bacteremic infant of that GA, but two infants were asymptomatic at diagnosis. There were two recurrences and seven deaths (six in preterm infants), but the role of Brucella infection in the deaths was not clear.

CONCLUSION

Brucellosis remains a concern in endemic countries, adversely affecting pregnancy and very rarely causing neonatal infection. Prematurity appeared to be the prime cause of death in neonates with congenital brucellosis.

Pediatric brucellosis. An update review for the new millennium

Brucellosis remains the most common bacterial zoonotic infection in many countries worldwide. Despite being long recognized and controllable, the disease still causes substantial morbidity, affecting especially the young population. The aim of this review is to provide insight to the epidemiology, etiology, clinical features, diagnosis, and management of childhood brucellosis.