Zeynep AKÇAM, Güler YAYLI, Ahmet AKKAYA, Önder ÖZTÜRK, Ünal ŞAHİN, Ahmet BİRCAN

Nadir bir pnömoni etkeni: Brucella melitensis

Bruselloz, dünya genelinde özellikle gelişmekte olan ülkelerde bir halk sağlığı sorunu olarak görülmeye devam etmektedir. Solunum sistemini tuttuğu bilinmesine rağmen nadiren görülen brusellozun klinik bulguları ve komplikasyonları tanının konmasını zorlaştırmaktadır. Bu nedenle, kronik öksürük, balgam çıkarma, hemoptizi ve ateş şikayetleri ile başvuran 57 yaşındaki erkek hastada, Brucella melitensis’in neden olduğu kanıtlanan pnömoni olgusunu sunmaktayız.

A rare agent of pneumonia: Brucella melitensis

Brucellosis remains a world-wide public health problem especially in developing brucellosis remains a world-wide public health problem especially in developing countries. Although involvement of the respiratory system in brucellosis is an acknowledged but rare event, its clinical manifestations and focal complications are often troublesome in making a diagnosis. Herein, we report a pneumonia case which proved due to Brucella melitensis in a 57-year-old man who presented with chronic cough, sputum, hemoptysis and fever.

PDF

___

1. Young EJ. Brucella species. In: Mandell GL, Bennett JE, Dolin R (eds). Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. 4th ed. New York: Churchill Livingstone, 1995: 2053-60.
2. Bilgehan H. Klinik Mikrobiyoloji, Özel Bakteriyoloji ve Bakteri Enfeksiyonları. İzmir: Doğruluk Matbaası, 1990:155-66.
3. Reisman EM, Colquitt LA, Childers J, Preminger GM. Brucella orchitis: A rare cause of testicular enlargement. J Urol 1990; 143: 821-2.
4. Sünbül M. Bruselloz. İnfeksiyon 2001; 33-8.
5. Beyazova U, Turan Ö, Şahin F, Sultan N. Brucella pnömonisi: Olgu sunumu, 17. ANKEM Kongresi, 26-30 Mayıs Antalya 2002, Özet Kitabı, Sayfa: 139.
6. Lubani MM, Lutu AR, Araj GF, et al. Pulmonary brucellosis. QJ Med 1989; 264: 319-24.
7. Pappas G, Bosilkovski M, Akritidis N, et al. Brucellosis and the respiratory system. Clin Infect Dis 2003; 37: 95-9.
8. Kochar DK, Sharma BV, Gupta S, et al. Pulmonary manifestations in brucellosis: A report on seven cases from Bikaner (north-west India). J Assoc Physicians India 2003;51: 33-6.
9. Hatipoglu CA, Bilgin G, Tulek N, Kosar U. Pulmonary involvement in brucellosis. J Infect 2005; 51: 116-9. Epub2004 Nov 11.
10. Johnson CC, Finegold SM. Pyogenic bacterial pneumonia, lung abscess, and empyema. In: Murray JF, Nadel JA (eds). Textbook of Respiratory Medicine. 2nd ed. Philadelphia: WB Saunders Company, 1994: 1036-93.
11. Dajani YF, Masoud AA, Barakat HF. Epidemiology and diagnosis of human brucellosis in Jordan. J Trop Med Hyg 1989; 92: 209-14.
12. Mousa AM, Elhag KM, Khogali M, Sugathan TN. Brucellosis in Kuwait: Aclinico-epidemiological study. Trans R Soc Trop Med Hyg 1987; 81: 1020-1.
13. Weinberg AN, Heller HM. Zoonotic and other bacterial pneumonias. In: Fishman AP (ed). Fishman’s Pulmonary Diseases and Disorders. 3rd ed. New York: McGraw Hill, 1998: 2413-30.
14. Sanford JP. Brucella pneumonia. Semin Respir Infect 1997; 12: 24-7.
15. Anonymous. Joint FAO/WHO expert committee on brucellosis. WHO Tech. Rep Ser 1986; 740: 1-32.
16. Ranjbar M, Keramat F, Mamani M, et al. Comparison between doxycycline-rifampin-amikacin and doxycyclinerifampin regimens in the treatment of brucellosis. Int J Infect Dis 2006 Jun 21; [Epub ahead of print].
17. Acocella G, Bertrand A, Beytout J, et al. Comparison of three different regimens in the treatment of acute brucellosis: A multicenter, multinational study. J Antimicrob Agents Chemother 1989; 23: 433-9.
18. Akova M, Uzun O, Akalın HE, et al. Quinolonesin treatment of human brucellosis: Comparative trial of ofloxacin- rifampin versus doxycycline-rifampin. Antimicrob Agents Chemother 1993; 37: 1821-4.
19. Falagas ME, Bliziotis IA. Quinolones for treatmnet of human brucellosis: Critical review of the evidence from microbiological and clinical studies. Antimicrob Agents Chemother 2006; 22-33.
20. Al Sibai MB, Halim MA, el Shaker MM, et al. Efficacy of ciprofloxacin for treatment of Brucella melitensis infections. Antimicrob Agents Chemother 1992; 36: 150-2.
21. Doganay M, Aygen B. Use of ciprofloxacin in the treatment of brucellosis. Eur J Clin Microbiol Infect Dis 1992;11: 74-5.
22. Pappas G, Seitaridis S, Akritidis N, Tsianos E. Treatmnet of brucella spondylitis: Lessons from an impossible meta- analysis and initial report of efficacy of a fluoroquinolone- containing regimen. Int J Antimicrob Agents 2004;24: 502-7.
23. Yilmaz E, Parlak M, Akalin H, et al. Brucellar spondylitis: Review of 25 cases. J Clin Rheumatol 2004; 10: 300-7.
24. Bayindir Y, Sonmez E, Aladag A, Buyukberber N. Comparison of five antimicrobial regimens for the treatment of brucellar spondylitis: A prospective, randomized study. J Chemother 2003; 15: 466-71.
25. Akdeniz H, Irmak H, Anlar O, Demiroz AP. Central nervous system brucellosis: Presentation, diagnosis and treatment. J Infect 1998; 36: 297-301.
26. Yavuz T, Ozaydin M, Ulusan V, et al. A case of mitral stenosis complicated with seronegative brucella endocarditis. Jpn Heart J 2004; 45: 353-8.
27. Pappas G, Christou L, Akritidi N, Tsianos EV. Quinolones for brucellosis: Treating old diseases with new drugs. Clin Microbiol Infect 2006; 12: 823-5.