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Congenital Brucellosis: A Case Report
Dan Xu1, Xuejing Li1, Beilei Cheng1
1Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
Vector Borne and Zoonotic Diseases (Larchmont, N.Y.)
|September 17, 2021
Summary
Congenital brucellosis, a rare vertical transmission of Brucella infection, occurred in an infant. Diagnosis was confirmed by pathogen detection in the mother's placenta, highlighting challenges in infant treatment and relapse management.
Area of Science:
- Infectious Diseases
- Neonatology
- Microbiology
Background:
- Brucellosis is a prevalent zoonotic infection globally, primarily caused by the bacterial genus Brucella.
- Human-to-human transmission is rare, with limited documented cases of vertical transmission.
- Congenital brucellosis presents a diagnostic and therapeutic challenge, particularly in non-endemic regions.
Observation:
- A 34-day-old infant presented with persistent fever, diagnosed with Brucellosis and Brucella melitensis meningitis.
- The infant exhibited hyperbilirubinemia and liver dysfunction.
- The mother experienced symptoms prior to delivery, and Brucella melitensis DNA was detected in her placental specimen, confirming chorioamnionitis.
Findings:
- The infant's brucellosis and meningitis relapsed multiple times despite initial antibiotic treatments.
- Treatment involved rifampicin, meropenem, and sulfamethoxazole/trimethoprim (SMZ/TMP), with chronic brucellosis requiring multiple therapy courses.
- Next-generation sequencing and microscopy confirmed Brucella melitensis in the maternal placental tissue.
Implications:
- This case underscores the importance of considering congenital brucellosis even in areas without widespread outbreaks.
- Effective treatment strategies for infant brucellosis require careful consideration of drug choices and potential for disease relapse.
- Early diagnosis and intervention are crucial for managing this rare but serious condition in neonates.
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