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[Brucellosis in a 3 month-old infant]
E Varon1, R Cohen, C A Bouhanna
1Services de Microbiologie et de Néonatologie, Hôpital Intercommunal de Créteil.
Abstract:
During the course of a bronchiolitis in a 3 month-old child, one blood culture yielded Brucella melitensis. The diagnosis of brucellosis is difficult in infancy because the symptoms are nonspecific and the disease may be mild and self-limited. The child received only breast milk and dietetic preparations. So, the detection in the maternal serum of a significant titer of Brucella agglutinin enabled us to consider the very rare human-to-human transmission from mother to child. Because the efficacy of ceftriaxone assessed by a favorable initial response, and in order to avoid complications due to the use of tetracyclines and cotrimoxazole in infant, our patient was successfully treated with ceftriaxone plus rifampin.
Insights
Brucellosis in infants is challenging to diagnose. This case highlights rare human-to-human transmission from mother to child, successfully treated with ceftriaxone and rifampin.
Area of Science:
- Pediatric Infectious Diseases
- Bacterial Pathogenesis
- Neonatal Immunology
Context:
- Brucellosis is a zoonotic disease with nonspecific symptoms in infants, making diagnosis difficult.
- Infantile brucellosis can be mild and self-limiting, complicating early detection and treatment.
- This case involves a 3-month-old infant diagnosed with Brucella melitensis during bronchiolitis.
Purpose:
- To report a rare case of human-to-human Brucella melitensis transmission from mother to infant.
- To discuss the diagnostic challenges of infantile brucellosis.
- To evaluate a treatment regimen for pediatric brucellosis.
Summary:
- A 3-month-old infant with bronchiolitis presented with Brucella melitensis bacteremia.
- Maternal serum revealed high Brucella agglutinin titers, suggesting mother-to-child transmission via breastfeeding.
- The infant was successfully treated with ceftriaxone and rifampin, avoiding potential complications from other antibiotics.
Impact:
- This case underscores the importance of considering brucellosis in infants, even with nonspecific symptoms.
- It highlights a rare route of transmission (mother-to-child) and informs diagnostic approaches.
- Successful treatment with ceftriaxone and rifampin provides a viable therapeutic option for pediatric brucellosis.