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由林鼠病原体新墨西哥布鲁氏菌引起的布鲁氏菌病:两例报告。

Brucellosis caused by the wood rat pathogen Brucella neotomae: two case reports.

作者信息

Villalobos-Vindas Juan M, Amuy Ernesto, Barquero-Calvo Elías, Rojas Norman, Chacón-Díaz Carlos, Chaves-Olarte Esteban, Guzman-Verri Caterina, Moreno Edgardo

机构信息

Caja Costarricense de Seguro Social, San José, Costa Rica.

Programa de Investigación en Enfermedades Tropicales, Universidad Nacional, Heredia, Costa Rica.

出版信息

J Med Case Rep. 2017 Dec 19;11(1):352. doi: 10.1186/s13256-017-1496-8.

Abstract

BACKGROUND

Brucellosis is a chronic bacterial disease caused by members of the genus Brucella. Among the classical species stands Brucella neotomae, until now, a pathogen limited to wood rats. However, we have identified two brucellosis human cases caused by B. neotomae, demonstrating that this species has zoonotic potential.

CASES PRESENTATION

Within almost 4 years of each other, a 64-year-old Costa Rican white Hispanic man and a 51-year-old Costa Rican white Hispanic man required medical care at public hospitals of Costa Rica. Their hematological and biochemical parameters were within normal limits. No adenopathies or visceral abnormalities were found. Both patients showed intermittent fever, disorientation, and general malaise and a positive Rose Bengal test compatible with Brucella infection. Blood and cerebrospinal fluid cultures rendered Gram-negative coccobacilli identified by genomic analysis as B. neotomae. After antibiotic treatment, the patients recovered with normal mental activities.

CONCLUSIONS

This is the first report describing in detail the clinical disease caused by B. neotomae in two unrelated patients. In spite of previous claims, this bacterium keeps zoonotic potential. Proposals to generate vaccines by using B. neotomae as an immunogen must be reexamined and countries housing the natural reservoir must consider the zoonotic risk.

摘要

背景

布鲁氏菌病是一种由布鲁氏菌属成员引起的慢性细菌性疾病。在经典物种中,布鲁氏菌新墨西哥种(Brucella neotomae)较为突出,直到现在,它还是一种仅限于林鼠的病原体。然而,我们已经确定了两例由布鲁氏菌新墨西哥种引起的人类布鲁氏菌病病例,这表明该物种具有人畜共患病的潜力。

病例介绍

在彼此相隔近4年的时间里,一名64岁的哥斯达黎加白人西班牙裔男子和一名51岁的哥斯达黎加白人西班牙裔男子在哥斯达黎加的公立医院接受治疗。他们的血液学和生化参数均在正常范围内。未发现淋巴结病或内脏异常。两名患者均表现出间歇性发热、定向障碍和全身不适,且玫瑰红试验呈阳性,与布鲁氏菌感染相符。血液和脑脊液培养出革兰氏阴性球杆菌,经基因组分析鉴定为布鲁氏菌新墨西哥种。经过抗生素治疗,患者恢复正常精神活动。

结论

这是第一份详细描述两名无关患者由布鲁氏菌新墨西哥种引起的临床疾病的报告。尽管此前有说法,但这种细菌仍有人畜共患病的潜力。使用布鲁氏菌新墨西哥种作为免疫原生产疫苗的提议必须重新审视,且存在该天然宿主的国家必须考虑人畜共患病风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fd9/5735802/c738764ebd5e/13256_2017_1496_Fig1_HTML.jpg

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