Title: Fever with pancytopenia:  Ask and look to find the cause

Authors: H. Subramony M.D., Mathi Manoj Kumar R

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.162

Abstract

Introduction

Brucellosis is the most common bacterial zoonotic disease encountered worldwide1 and is endemic in the Mediterranean countries of Europe, north and east Africa, the Middle East, south and central Asia and Central and South America and yet it is often unrecognized and frequently goes unreported2. The infection is transmitted to humans by animals through direct contact with infected materials like afterbirth or indirectly by ingestion of animal products and by inhalation of airborne agents. Consumption of raw milk and cheese made from raw milk (fresh cheese) is the major source of infection in man. The bacterium survives for 6 weeks at 4° C in cream, 30 days in icecream, and 15 to 100 days in fresh cheese3.4. It is also an occupational disease for people who work in the livestock sector. It is also a Class B Bioterrorist agent5 and is one of the highly neglected tropical diseases.

References

  1. Bosilkovski M, Dimzova M, Grozdanovski K. Natural history of brucellosis in an endemic region in different time periods. Acta Clin Croat. 2009;48:41-46.
  2. http://www.who.int/csr/resources/publications/Brucellosis.pdf
  3. Davies G, Casey A. The survival of Brucella abortus in milk and milk products. Br Vet J. 1973;129:345-353.
  4. Nicoletti P. Relationship between animal and human disease. In: Young EJ, Corbel MJ, eds. Brucellosis: Clinical and Laboratory Aspects. Boca Raton, FL: CRC Press; 1989: 41-45.
  5. Greenfi eld RA, Drevets DA, Machado LJ. Bacterial pathogens as biological weapons and agents of bioterrorism. Am J Med Sci 2002; 323: 299-315.
  6. Biosci. 33(4), November 2008, 539–547, © Indian Academy of Sciences
  7. http://www.fao.org/docrep/article/agrippa/657_en.htm
  8. Renukaradhya, G., Isloor, S. and Rajasekhar, M. (2002). Epidemiology, zoonotic aspects, vaccination and control/eradication of brucellosis in India. Veterinary Microbiology, 90(1-4), pp.183-195.).
  9. Franco MP, Mulder M, Gilman RH, et al. Human brucellosis. Lancet Infect Dis. 2007;7:775-786.
  10. Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis 2007; 7(12):775-786.
  11. Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore). 1996;75:195 211.
  12. Mandell, G. and Douglas, R. (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 8th ed. Philadelphia, Pa: Elsevier, Saunders, p.2585.
  13. Troy SB, Rickman LS, Davis CE. Brucellosis in San Diego: epidemiology and species-related differences in acute clinical presentations. Medicine (Baltimore). 2005;84: 174-187.
  14. Kadri SM, Ruksana A, Laharwal MA, Tanvir M. Seroprevalence of brucellosis in Kashmir [India] among patients with pyrexia of unknown origin. J Indian Med Assoc 2000;98:170-1.
  15. Sharma VD, Sethi MS, Yadav MP, Dube DC. Sero-epidemiologic investigations on brucellosis in the states of Uttar Pradesh [U.P.] and Delhi [India]. Int J Zoonoses 1979;6:75-81.
  16. Appannanavar SB, Sharma K, Verma S, Sharma M. Seroprevalence of Brucellosis: A 10-year experience at a tertiary care center in north India. Indian J Pathol Microbiol 2012;55:271-2.
  17. Priyadarshini A, Sarangi LN, Palai TK, Panda HK, Mishra R, Behera PC. Brucellosis in cattle and occupationally exposed human beings: A Serosurvey in Odisha, India. J Pure Appl Microbiol 2013;7:3255-60.
  18. Agasthya AS, Isloor S, Prabhudas K. Brucellosis in high risk group individuals. Indian J Med Microbiol 2007;25:28-31.
  19. Yohannes M, Gill JP. Seroepidemiological survey of human brucellosis in and around Ludhiana, India. Emerg Health Threats J 2011;4:7361.
  20. Al Dahouk S, Nöckler K. Implications of laboratory diagnosis on brucellosis therapy. Expert Rev Anti Infect Ther 2011;9:833–45.
  21. Pathak AD, Dubal ZB, Doijad S, et al. Human brucellosis among pyrexia of unknown origin cases and occupationally exposed individuals in Goa Region, India. Emerging Health Threats Journal. 2014;7:10.3402/ehtj.v7.23846. doi:10.3402/ehtj.v7.23846.
  22. Farrar, J. and Manson, P. (2014). Manson's Tropical diseases. 23rd ed. elsevier, p.376.
  23. J Assoc Physicians India. 2007 Apr; 55:271-5. Hospital-based case series of 175 cases of serologically confirmed brucellosis in Bikaner. Kochar DK, Gupta BK
  24. Prasad, S. and Tanveer, K. (2013). Brucella infections in high-risk population and in patients hospitalized for fever: A serological study at Kolar, Karnataka. Annals of Tropical Medicine and Public Health, 6(5), p.549.
  25. Vassallo DJ. The corps disease: brucellosis and its historical association with the Royal Army Medical Corps. J R Army Med Corps. 1992;138:140-150.
  26. Piqueras M. Microbiology: a dangerous profession? Int Microbiol. 2007;10:217-226.
  27. Hall WH. Brucellosis. In: Evans AS, Brachman PS, eds. Bacterial Infections of Humans, Epidemiology and Control. 2nd ed. New York: Plenum; 1991:133-149.
  28. Sathyanarayanan, V. and Razak, A. (2011). Clinical profile of brucellosis from a tertiary care center in southern India. Asian Pacific Journal of Tropical Medicine, 4(5), pp.397-400.
  29. Hauser, S., Longo, D., Loscalzo, J. and Harrison, T. (2015). Harrison's principles of internal medicine. 19th ed. McGraw-Hill, pp.194e-2.
  30. Pappas G, Akritidis N, Bosilkovski M, et al. Brucellosis. N Engl J Med. 2005;352:2325-2336.
  31. Buzgan T, Karahocagil MK, Irmak H, et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis. 2010;14:e 469-e478.
  32. Calik S, Gokengin D. Human brucellosis in Turkey: a review of the literature between 1990 and 2009. Turk J Med Sci. 2011;41:549-555.
  33. Chin Med J (Engl). 2012 Jun;125 (11): 1871-6. Bone marrow biopsy findings in brucellosis patients with hematologic abnormalities. Demir C , Karahocagil MK
  34. Christopher S, Umapathy BL, Ravikumar KL. Brucellosis: review on the recent trends in pathogenicity and laboratory diagnosis. J Lab Physicians. 2010;2:55-60.
  35. Gotuzzo E, Carrillo C, Guerra J, et al. An evaluation of diagnostic methods for brucellosis—the value of bone marrow culture. J Infect Dis. 1986;153:122-125.

Corresponding Author

Dr H Subramony

Consultant Physician, Apollo Hospitals, Greams Road, Chennai 600006, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., PH: 9841073910