Brucellosis in dialysis patients. Does it exist?

Area of Science:

• Infectious Diseases
• Nephrology
• Public Health

Background:

• Brucellosis is a zoonotic disease affecting humans, diagnosed via culture or serology combined with clinical signs.
• Dialysis patients have compromised immune systems, increasing susceptibility to infections like brucellosis.
• A significant increase in brucellosis cases was observed in dialysis patients over the past year, contrasting with previous years.

Purpose of the Study:

• To report a high incidence of brucellosis among dialysis patients.
• To investigate the risk factors and clinical presentation of brucellosis in this vulnerable population.

Main Methods:

• Retrospective study of 8 dialysis patients (5 hemodialysis, 3 peritoneal dialysis) diagnosed with brucellosis.
• Diagnosis confirmed by clinical symptoms, signs, and polymerase chain reaction (PCR) analysis of peripheral blood.
• Data collected on patient demographics, living environment, dietary habits, and treatment outcomes.

Main Results:

• Eight out of 124 dialysis patients developed brucellosis, with a mean age of 67 years.
• All affected patients resided in areas with prevalent animal brucellosis and consumed unpasteurized milk and cheese.
• Clinical presentation was mild, characterized by low-grade fever and influenza-like symptoms. PCR confirmed the infection.

Conclusions:

• Dialysis patients are susceptible to brucellosis, particularly when exposed to contaminated animal products.
• Consumption of unpasteurized milk, cheese, and undercooked meat from infected animals in endemic areas are significant risk factors.
• Treatment with doxycycline and rifampicin for 6 weeks resulted in no relapses in the studied patients.