Human bovine tuberculosis - remains in the differential

Area of Science:

• Veterinary Medicine
• Infectious Diseases
• Public Health

Background:

• Mycobacterium bovis (M. bovis) is a significant cattle pathogen.
• Human infection with M. bovis, or bovine tuberculosis, occurs through unpasteurized milk or aerosol exposure.
• Despite control measures, M. bovis remains a public health concern.

Observation:

• Two human cases of bovine tuberculosis are presented: one presumptive and one confirmed.
• The confirmed case demonstrated transmission within a household.
• The M. bovis strain in the confirmed case exhibited isoniazid resistance, alongside pyrazinamide resistance.

Findings:

• Both patients responded effectively to antituberculous therapy.
• Rifampicin prophylaxis was administered to an exposed household contact.
• Isoniazid resistance was observed in an immunocompetent patient, a notable deviation from previous observations in immunocompromised individuals.

Implications:

• Highlights the ongoing need for clinical suspicion of bovine tuberculosis in at-risk populations with potential exposure.
• Underscores the importance of considering M. bovis as a cause of tuberculosis, even in immunocompetent individuals.
• The emergence of isoniazid resistance in M. bovis warrants further investigation and surveillance in human populations.