1/9. Human infection with M- strain of brucella canis.The less mucoid strain of brucella canis or M- strain is used for the serologic diagnosis of canine brucellosis. While this strain is avirulent in dogs, we report the case of clinical brucellosis that developed in a laboratory worker a few days after handling live M- cells for antigen production.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/9. Unusual clinical presentation of brucellosis caused by brucella canis.brucella canis is considered a rare cause of human brucellosis. The clinical importance of this infection may have been underestimated so far because of difficulties with presumptive diagnosis. The case described here presented symptoms compatible with brucellosis but the routine tests using brucella abortus antigen were negative. The infection would have remained undiagnosed if culture had not been positive. This case illustrates the potential for a favourable outcome in brucella canis diagnosis and supports recommendations for the use of B. canis serology. The infection should be suspected in patients with compatible symptoms and negative serology for B. abortus antigen.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
3/9. Correlation of antigenic expression with progress in antibiotic therapy of acute human brucellosis.Human brucellosis is a zoonotic disease which is endemic in saudi arabia. The aim of this study was to investigate the humoral immune responses and identify the target antigens that persist at different stages in human brucellosis during antibiotic therapy. To do this, an acute case of accidental nosocomial infection was studied experimentally. blood was collected from the patient at the time of diagnosis, and at weekly intervals during therapy until remission. IgG and IgM immunoblotting was used to characterize specific antigenic determinants, and ELISA antibody titration was performed to quantify the circulating antibodies. Results indicated that protein bands of 12-13.5 kDa bound IgG in the patient's sera but did not bind IgM on immunoblots and are probably not specific for, or important in, early stage infections. However, an 18 kDa band persisted during infection through remission. The pivotal and most important findings were that the number of protein bands seen on immunoblots, the magnitude of ELISA antibody titres and the concomitant changes in the intensity of the polypeptide bands of 42-43 kDa were positively correlated with the stage of infection. High numbers of anti-IgG and -IgM immunoblot bands coupled with high ELISA antibody titres and a concomitant increase in intensity of the 42-43 kDa bands were positively correlated with acute and severe infection. Conversely, a reduction in the number of polypeptide bands as well as a decrease in the intensity, until the complete disappearance of the 42-43 kDa bands, coupled with low (baseline) ELISA antibody titration values indicated successful treatment and remission. The routine use of the methods described here to ascertain the stage of the disease, assess the progress of antimicrobial therapy and monitor cases of relapse in human brucellosis is suggested.- - - - - - - - - - ranking = 6keywords = antigen (Clic here for more details about this article) |
4/9. brucellosis: an unusual diagnosis for a seronegative patient with abscesses, osteomyelitis, and ulcerative colitis.A 16-year-old girl developed multiple subcutaneous abscesses, osteomyelitis, and severe colitis. On the patient's second admission, a single blood culture--and, subsequently, a specimen of pus--yielded brucella melitensis biovar 1. A second set of serologic tests, including the rose bengal test, the standard tube agglutination test, the CF test, and Coombs' test, were all negative for Brucella on the patient's second admission and 1 month later. However, a lymphocyte proliferation assay with extracted antigen of Brucella was markedly positive. Thus, this case illustrates that patients with B. melitensis infection may have a unique clinical presentation and that the lymphocyte proliferation assay is an important diagnostic tool for patients whose serologic test results are negative but for whom brucellosis is suspected.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/9. brucella canis: an infectious cause of prolonged fever of undetermined origin.We have reported a case documenting the difficulties encountered in diagnosing and treating patients with brucellosis caused by brucella canis, including the nonspecific clinical presentation, low level of intermittent bacteremias, the slow-growing, fastidious nature of the organism, and the lack of antigenic cross-reactivity with the antigens usually used in routine Brucella serology. Further, the predominant southeastern united states epidemiology of this organism and the importance of exposure to dogs are also demonstrated by this report. It is important that physicians caring for patients in this region of the country be aware of the epidemiologic, serologic, and microbiologic pitfalls encountered in diagnosing B canis infections.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
6/9. Tissue typing in brucellosis.The index case in this report was clinically, epidemiologically, and serologically proved to be suffering from acute brucellosis acquired in Britain and complicated by acute intractable reactive arthritis. HLA tissue typing was A1, A2, B7, and B27. As there is no information available about HLA typing in brucellosis in Britain, we examined further cases of human brucellosis retrospectively. Three further patients possessing B27 antigen were identified, only one of whom had had reactive arthritis. Eight of the 12 cases studied also carried A2, which is thus shown not to be protective against the development of brucellosis as had been suggested previously.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/9. sulfisoxazole-induced thrombocytopenic purpura. Immunologic mechanism as cause.During treatment of brucellosis with sulfisoxazole, tetracycline, and streptomycin sulfate, severe thrombocytopenic purpura developed in a young farmer. Verification for an immune mechanism was provided by clinical challenge with a small dose of sulfisoxazole that caused recurrence of thrombocytopenia and by serologic laboratory test results that detected a serum factor causing platelet agglutination requiring the presence of sulfisoxazole. The original antigenic stimulation was considered to come from drinking cows' milk contaminated with sulfonamide drugs. Cross-reactivity with some other sulfonamide drugs was demonstrated.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/9. Articular involvement in human brucellosis: a retrospective analysis of 304 cases.brucellosis is a zoonosis which in humans is caused by one of four species of the Brucella genus: B. melitensis, B. abortus, B. suis and B. canis. B. abortus is the species prevalent in north america and europe and B. melitensis in most developing countries. Differences in disease manifestations may be accounted for either by differences in the species or by differences in the host. Articular involvement in brucellosis, although recognized since 1904, has been variably emphasized. Three hundred and four cases of human brucellosis caused by B. melitensis, the prevalent species in peru, were seen during a 12-yr period in one Lima hospital. fever, malaise and hepatomegaly were the most frequent findings. diagnosis was greatly improved when cultures were done in the biphasic Ruiz-Castaneda medium, rather than in trypticase soy broth. Serologic diagnosis is still important, and it should include standard tube testing, detection of IgG blocking antibodies and fractionation with 2-ME in chronic cases. The disease may take one of three courses: acute, (< 8 wk), chronic (> 8 wk) or undulant (periods of remissions and exacerbations). Four syndromes were recognized in a total of 33.8% of patients with brucellosis. The most frequent pattern (in approximately 46.6% of patients with arthritis) was sacroiliitis, usually non-destructive and either uni- or bilateral. The second most frequent articular syndrome was peripheral arthritis (38.8%), manifested either as a single large lower extremity joint or as an asymmetric pauciarthritis. Rarely patients presented with a rheumatoid-like arthritis. Mixed arthritis (7.8%) was a combination of the first two. The above forms occurred in patients with an acute or undulant course. spondylitis was the least common form of arthritis (6.8%), and differed significantly from the other forms of arthritis in the duration of symptoms (chronic course), age of patients (older individuals) and the paucity of fever and malaise. It also tended to be destructive. The arthritis usually resolved with the combined regimen of tetracycline (2 g p.o. for 21 days) and streptomycin (1 g i.m. for 21 days) without sequelae. Illustrative cases of these syndromes are presented. The relatively benign nature of most of the patients with bruccellar arthritis lead us to postulate that they are for the most part reactive arthritides. Host factors are thought to be important in determining the response to the infection, but they are yet to be identified. Our own genetic studies have failed to identify an increased frequency of B27 or CREG antigens in the patients with sacroiliitis.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/9. Interferon-A 2a administration in chronic anergic brucellosis.Two cases with chronic anergic brucellosis are described. Both patients suffered repeated disease relapses and responded poorly to conventional treatment. The immunologic research revealed that both patients were anergic to brucella antigens and immunocompromised. In an effort to restore patients' defective immune responses, we administered Interferon-A 2a during a six month treatment period as follows: a) loading dose- 3MU SC 3 days/week for an 8 week trial, followed by, b) maintenance period- 3MU SC three times/week. Our results showed that IFN administration induced clinical remission in both patients by the end of the 4th month of treatment. Additionally, Coombs' agglutination titers decreased gradually, the leucocyte migration index and the skin tests developed "energy" to antigens and the monocyte macrophage function tests were restored to normal. We concluded that IFN treatment can be beneficial in chronic anergic brucellosis by restoring defective immune responses, promoting therefore a sufficient inflammatory response against brucella infection.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |