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Brucella melitensis: an unexpected isolate from cerebrospinal fluid

P F Wheat1, D J Dabbs, K J Thickett

  • 1Microbiology Department, Royal Hallamshire Hospital.

Communicable Disease Report. CDR Review
|March 31, 1995
PubMed
Summary

Laboratory personnel should maintain high biosafety precautions for cerebrospinal fluid specimens from endemic regions. Initial handling as potentially infectious, even if misidentified, prevents exposure to dangerous pathogens like Brucella melitensis.

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Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Biosafety

Background:

  • Cerebrospinal fluid (CSF) analysis is crucial for diagnosing neurological infections.
  • Patients from regions endemic for tuberculosis and HIV may present with complex infectious profiles.
  • Initial identification of microbial isolates can be challenging and prone to error.

Observation:

  • A CSF specimen was initially managed under strict safety precautions due to the patient's origin from Somalia.
  • An isolate, initially presumed to be a Neisseria species, was later identified as Brucella melitensis.
  • The organism was handled on an open bench after initial misidentification, posing a potential biosafety risk.

Findings:

  • Brucella melitensis was identified in a cerebrospinal fluid specimen.

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  • The initial misidentification of the isolate as Neisseria species led to downgraded biosafety measures.
  • The case underscores the importance of considering Brucella in differential diagnoses for CSF infections from endemic areas.

    • Implications:

    • Laboratory protocols for handling cerebrospinal fluid specimens must account for the potential presence of Brucella, especially in patients from endemic regions.
    • Enhanced vigilance and confirmatory testing are essential to prevent laboratory-acquired infections.
    • This case highlights the need for continuous training and adherence to safety guidelines in clinical microbiology laboratories.