Infect Chemother.  2018 Jun;50(2):149-152. 10.3947/ic.2018.50.2.149.

An Imported Case of Brucella melitensis Infection in South Korea

• Lee JY
• Jeon Y
• Ahn MY
• Ann HW
• Jung IY
• Jung W
• Kim MH
• Ahn JY
• Song JE
• Kim YC
• Oh DH
• Kim EJ
• Jeong SJ
• Ku NS
• Kim H
• Lee K
• Kim JM
• Choi JY

• KMID: 2415037
• DOI: http://doi.org/10.3947/ic.2018.50.2.149

Abstract

Brucellosis is a zoonotic infection that is usually transmitted from cattle to humans through ingestion of animal milk, direct contact with animal parts, or inhalation of aerosolized particles. In Korea, brucellosis seem to be transmitted through close contact with blood, fetus, urine, and placenta of domestic cow that has been infected by Brucella abortus, or inhalation of B. arbortus while examining or slaughtering cow. Brucella melitensis infection is rare in Korea and there have been no reported cases of B. melitensis originating from other countries until now. This report details a case of complicated brucellosis with infective spondylitis in a 48-year-old male construction worker recently returned from Iraq. Infection with B. melitensis was confirmed using 16s rRNA sequencing and omp31 gene analysis. The patient was successfully treated using a combination of rifampin, doxycycline, and streptomycin, in accordance with WHO guidelines. This is the first reported case of complicated brucellosis with infective spondylitis in Korea caused by B. melitensis originating from Iraq.

Keyword

Brucella melitensis; Brucellosis; Infective spondylitis; Middle East; Korea

MeSH Terms

Animals
Brucella abortus
Brucella melitensis*
Brucella*
Brucellosis
Cattle
Doxycycline
Eating
Fetus
Humans
Inhalation
Iraq
Korea*
Male
Middle Aged
Middle East
Milk
Placenta
Rifampin
Spondylitis
Streptomycin
Zoonoses
Doxycycline
Rifampin
Streptomycin

Figure

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  Figure 1 T2 added sagittal magnetic resonance image (contrast) of the lumbar spine taken on the third hospital day, showing pyogenic spondylitis involving L5 with phlegmon as well as posterior extension to the epidural space at the L5 and S1 levels (arrows).

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  Figure 2 Gram stain of patient’s blood culture on the third hospital day. On Gram stain, the organisms appeared as faintly stained, Gram negative coccobacilli (×400).

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  Figure 3 BSCP31 gene targeted PCR and Brucella melitensis specific primer. The 1st lane is the ladder. The 2nd lane is BSCP31 gene targeted PCR using a specimen obtained from patient that shows a BCSP31 band at the 223 bp. The 3rd lane is PCR using a B. melitensis specific primer (IS711) with a specimen obtained from the patient that shows an IS711 band at the 731 bp.

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