Potasman I, Even L, Banai M, Cohen E, Angel D, Jaffe M
Department of Pediatrics, Bnai Zion Medical Center, Haifa, Israel.
Rev Infect Dis. 1991 Nov-Dec;13(6):1039-42. doi: 10.1093/clinids/13.6.1039.
A 16-year-old girl developed multiple subcutaneous abscesses, osteomyelitis, and severe colitis. On the patient's second admission, a single blood culture--and, subsequently, a specimen of pus--yielded Brucella melitensis biovar 1. A second set of serologic tests, including the rose bengal test, the standard tube agglutination test, the CF test, and Coombs' test, were all negative for Brucella on the patient's second admission and 1 month later. However, a lymphocyte proliferation assay with extracted antigen of Brucella was markedly positive. Thus, this case illustrates that patients with B. melitensis infection may have a unique clinical presentation and that the lymphocyte proliferation assay is an important diagnostic tool for patients whose serologic test results are negative but for whom brucellosis is suspected.
一名16岁女孩出现多处皮下脓肿、骨髓炎和严重结肠炎。患者第二次入院时，一次血培养以及随后的一份脓液标本培养出羊种布鲁氏菌生物变种1。在患者第二次入院时及1个月后进行的第二组血清学检测，包括玫瑰红试验、标准试管凝集试验、补体结合试验和库姆斯试验，布鲁氏菌检测结果均为阴性。然而，用提取的布鲁氏菌抗原进行的淋巴细胞增殖试验呈明显阳性。因此，该病例表明，羊种布鲁氏菌感染患者可能有独特的临床表现，淋巴细胞增殖试验对于血清学检测结果为阴性但怀疑患有布鲁氏菌病的患者是一种重要的诊断工具。
