Congenital Brucellosis: A Case Report

Brucellosis is the most common zoonotic infection worldwide, and is caused by bacterial genus Brucella. The disease is rarely transmitted through human-to-human transmission. Few cases have been reported about vertical transmission of human brucellosis. Herein, we reported a case of congenital brucellosis, with clear evidence of pathogen detected in mother's placental specimen. A 34-day-old girl was admitted to the department of pulmonology with fever for 8 days. Three blood samples and one sample of cerebrospinal fluid were positive for Brucella melitensis. The diagnosis of brucellosis and B. melitensis meningitis were established, along with hyperbilirubinemia and liver dysfunction. Treatment of rifampicin (for 6 weeks) and meropenem (for 2 weeks) was administered. However, the disease relapsed within 18 days. Thereafter, a combination therapy of rifampicin and sulfamethoxazole/trimethiprim (SMZ/TMP) was administered for 8 weeks. The disease relapsed again in 42 days. For chronic brucellosis, three courses of combination therapy of rifampicin and SMZ/TMP was administered. The mother had fatigue and arthralgia for 2 weeks, fever and membrane rupture 1 day before the baby was born. B. melitensis DNA was detected in the mother's placental specimen by next-generation sequencing and bacterial identification under microscope proved chorioamnionitis. We reported a confirmed case of congenital brucellosis. This disease should be closely monitored even in nonepidemic areas. The treatment of brucellosis in infancy faces challenges of drug choice and disease relapse.