PubMed · 10614086
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R Baños, J Gómez, E Simarro, M Vicente. 1999. [Liver abscess probably caused by Brucella].. https://pubmed.ncbi.nlm.nih.gov/10614086/
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A 97-kDa purified aminopeptidase N (PepN) of Brucella melitensis was previously identified to be immunogenic in humans. The B. melitensis pepN gene was cloned, expressed in Escherichia coli and purified by affinity chromatography. The recombinant PepN (rPepN) exhibited the same biochemical properties, specificity and susceptibility to inhibitors as the native PepN. rPepN was evaluated as a diagnostic antigen in an indirect enzyme-linked immunosorbent assay (ELISA) using sera from patients with acute and chronic brucellosis. The specificity of the ELISA was determined with sera from healthy donors. The ELISA had a cutoff value of 0.156 with 100% specificity and 100% sensitivity. Higher sensitivity was obtained using rPepN compared with crude extract from B. melitensis. Anti-PepN sera did not exhibit serological cross-reaction to crude extracts from Rhizobium tropici, Ochrobactrum anthropi, Yersinia enterocolitica 09 or E. coli O157H7.
Pleural involvement is a rare presentation of brucellosis. We report a patient referred for the evaluation of fever, right-sided pleural effusion and hilar lymph node enlargement. The pleural fluid revealed exudative characteristics with the predominance of neutrophils. Brucella melitensis was isolated from bone marrow, pleural effusion and blood cultures. The diagnosis was also confirmed by demonstration of a high Brucella agglutinin titre. The patient was successfully treated with rifampicin and doxicycline for three months.
We report a case of Brucella melitensis infection in an obstetrician who was infected during the delivery of an infant suffering from congenital brucellosis. The obstetrician was treated with doxycycline and rifampin and fully recovered. This is the first reported case of Brucella infection transmitted through infectious secretions at the delivery of a transplacentally infected newborn and emphasizes that, especially in endemic areas educational and technical measures are needed in order the obstetricians to avoid ingestion of secretions during clearance of the newborn's respiratory tract from saliva and amniotic fluid.