Brucellosis outbreak attributed to ingestion of umpasteurized goat cheese

In six cases of Brucella melitensis infections the common etiologic factor was the ingestion of raw goat cheese. Presenting complaints were variable, but a constant feature was persistent fevers that frequently were present for months. Evidence of liver cell dysfunction was present in each case, and in two, biopsy disclosed diffuse hepatitis with focal necrosis. The diagnoses were initially based on high titers of Brucella agglutinins and later confirmed by positive blood cultures. A good clinical response was induced by antibiotic therapy ( tetracycline plus streptomycin sulfate), but in two cases a Jarish-Herxheimer reaction occurred during the first 24 hours of treatment.