Ertem M, Kürekçi A E, Aysev D, Unal E, Ikincioğullari A
Ankara University School of Medicine, Department of Pediatrics, Pediatric Bone Marrow Transplantation Unit, Turkey.
Bone Marrow Transplant. 2000 Jul;26(2):225-6. doi: 10.1038/sj.bmt.1702480.
We report a unique case of brucellosis transmitted by BMT. An 8-year-old boy with the diagnosis of Fanconi's anemia received an allogeneic BMT from his HLA-identical sibling. Routine culture from the infused marrow suspension grew Brucella abortus on day +4 post BMT. Spiking fevers occurred on days +2 and +16. The first febrile episode responded to broad-spectrum antibiotic therapy. However, the second episode did not. B. abortus was isolated from blood cultures taken during the second febrile episode. The Brucella agglutination titer was negative. Antibiotic therapy with oral doxycycline and i.v. gentamycin was successful with no recurrence of infection during 13 months of follow-up. The donor's blood culture was also positive for B. abortus and Brucella antibodies were detectable at 1:320 titer when he presented with fever and hepatosplenomegaly on day +32. We emphasize the need to consider brucellosis in patients undergoing BMT. We suggest that donor and recipient be evaluated for brucellosis especially in countries where the incidence of this infection is relatively high.
我们报告了一例通过骨髓移植（BMT）传播布鲁氏菌病的独特病例。一名8岁被诊断为范可尼贫血的男孩接受了来自其HLA配型相同同胞的异基因骨髓移植。移植后第4天，输注的骨髓悬液常规培养长出流产布鲁氏菌。在移植后第2天和第16天出现高热。第一次发热发作对广谱抗生素治疗有反应。然而，第二次发作没有反应。在第二次发热发作期间采集的血培养中分离出流产布鲁氏菌。布鲁氏菌凝集试验滴度为阴性。口服强力霉素和静脉注射庆大霉素的抗生素治疗取得成功，在13个月的随访期间感染未复发。供者的血培养也显示流产布鲁氏菌阳性，当他在移植后第32天出现发热和肝脾肿大时，布鲁氏菌抗体滴度可检测到为1:320。我们强调在接受骨髓移植的患者中需要考虑布鲁氏菌病。我们建议对供者和受者进行布鲁氏菌病评估，尤其是在这种感染发病率相对较高的国家。
