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Brucellosis of the lung: case report and review of the literature

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Abstract

Human brucellosis is a worldwide re-emerging zoonosis. However, its histological appearance has only been occasionally described. We report the case of a young girl who had been suffering from a spontaneous fracture of the eighth thoracic vertebra at the age of 7. At the age of 15, X-ray showed a translucence of the seventh and ninth thoracic vertebra, and additionally, a bi-lateral episcleritis was detected. Three months later, she was admitted to the hospital because of perspiration at night and moderate fever. Computer tomography revealed coarsely spotted infiltrates in the lower fields of both lungs. Serology for rheumatic diseases was negative. Thoracoscopical wedge resection was done for histological clarification of pulmonary changes. Microscopically, a granulomatous inflammation with central necrosis was seen. A Ziehl–Neelsen stain did not demonstrate acid-fast bacteria. In spite of negative serology, real-time polymerase chain reaction detected Brucella melitensis deoxyribonucleic acid in the formalin-fixed tissue samples of the lung. Interrogation of the patient revealed visits in different Arabian countries during childhood as a presumable source of infection. In conclusion, granulomatous inflammation negative for Ziehl–Neelsen and Grocott stains presenting together with other localized lesions should lead to specific investigations on brucellosis.

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References

  1. Akhtar M (2001) Histopathological features. In: Madkour MM (ed) Makour’s brucellosis. Springer, Berlin, pp 65–73

    Google Scholar 

  2. Al-Anazi AR, Aziz S, Fouda MA (2005) Brucellosis: haemorrhagic pleural effusion. Med Princ Pract 14:118–120

    Article  PubMed  Google Scholar 

  3. Al Dahouk S, Nöckler K, Hensel A, Tomaso H, Scholz HC, Hagen RM, Neubauer H (2005) Human brucellosis in a nonendemic country: a report from Germany, 2002 and 2003. Eur J Clin Microbiol Infect Dis 24:450–456

    Article  PubMed  CAS  Google Scholar 

  4. Chavez CA, Veach GE (1976) Brucellosis. Localized pulmonary nodule due to Brucella suis. J Kansas Med Soc 76:434–437

    Google Scholar 

  5. Corbel MJ (1997) Brucellosis: an overview. Emerg Infect Dis 3:213–221

    Article  PubMed  CAS  Google Scholar 

  6. El-Zammar OA, Katzenstein ALA (2007) Pathological diagnosis of granulomatous lung disease: a review. Histopathology 50:289–310

    Article  PubMed  CAS  Google Scholar 

  7. European Food Safety Authority (2006) The community summary report on trends and sources of zoonoses, zoonotic agents, antimicrobial resistance and foodborne outbreaks in the European Union in 2005: Brucella. The EFSA Journal 94:146–159

    Google Scholar 

  8. Garcia-Rodriguez JA, Garcia-Sanchez JE, Munoz Bellido JL, Ortiz de la Tabla V, Bellido Barbero J (1988) Review of pulmonary brucellosis: a case report on brucellar pulmonary empyema. Diagn Microbiol Infect Dis 11:53–60

    Article  PubMed  CAS  Google Scholar 

  9. Godfroid J (2002) Brucellosis in wildlife. Rev Sci Tech 21:277–286

    PubMed  CAS  Google Scholar 

  10. Godfroid J, Cloeckaert A, Liautard J-P, Kohler S, Fretin D, Walravens K, Garin-Bastuji B, Letesson J-J (2005) From the discovery of the Malta fever’s agent to the discovery of a marine mammal reservoir, brucellosis has continuously been a re-emerging zoonosis. Vet Res 36:313–326

    Article  PubMed  Google Scholar 

  11. Hunt AC, Bothwell PW (1967) Histological findings in human brucellosis. J Clin Path 20:267–272

    Article  PubMed  CAS  Google Scholar 

  12. Lack EE, Connor DH (1997) Tuberculosis. In: Connor DH, Chandler FW, Schwartz DA, Manz HJ, Lack EE (eds) Pathology of infectious diseases. Appleton & Lange, Stamford, pp 857–868

    Google Scholar 

  13. Lefmann M, Schweickert B, Buchholz P, Gobel UB, Ulrichs T, Seiler P, Theegarten D, Moter A (2006) Evaluation of peptide nucleic acid-fluorescence in situ hybridization for identification of clinically relevant mycobacteria in clinical specimens and tissue sections. J Clin Microbiol 44:3760–3767

    Article  PubMed  CAS  Google Scholar 

  14. Pappas G, Bosilkovski M, Akritidis N, Mastora M, Krteva L, Tsianos E (2003) Brucellosis and the respiratory system. Clin Infect Dis e37:95–99

    Article  Google Scholar 

  15. Potasman I, Even L, Banai M, Cohen E, Angel D, Jaffe M (1991) Brucellosis: an unusual diagnosis for a seronegative patient with abscesses, osteomyelitis, and ulcerative colitis. Rev Infect Dis 13:1039–1042

    PubMed  CAS  Google Scholar 

  16. Ramah SJ, Chomet B, McLean J, Lemke C (1959) Pulmonary granuloma due to brucellosis. JAMA 170:1665–1667

    CAS  Google Scholar 

  17. Redkar R, Rose S, Bricker B, DelVecchio V (2001) Real-time detection of Brucella abortus, Brucella melitensis and Brucella suis. Mol Cell Probes 15:43–52

    Article  PubMed  CAS  Google Scholar 

  18. Rhyan JC, Gidlewski T, Roffe TJ, Aune K, Philo LM, Ewalt DR (2001) Pathology of brucellosis in bison from Yellowstone National Park. J Wildl Dis 37:101–109

    PubMed  CAS  Google Scholar 

  19. Takahashi H, Tanaka S, Yoshida K, Hoshino H, Sasaki H, Takahashi K, Kimura K, Fuji N, Kimura H, Mori M, Abe S (1996) An unusual case of brucellosis in Japan: Difficulties in the differential diagnosis from pulmonary tuberculosis. Intern Med 35:310–314

    PubMed  CAS  Google Scholar 

  20. Webb WA, Thoroughman JC (1966) Solitary pulmonary nodule due to Brucella suis. Report of a case. Dis Chest 49:222–224

    Article  PubMed  CAS  Google Scholar 

  21. Weed LA, Dahlin DC, Pugh DG, Ivins JC (1952) Brucella in tissues removed at surgery. Am J Clin Pathol 22:10–21

    PubMed  CAS  Google Scholar 

  22. Weed LA, Sloss PT, Clagett OT (1956) Chronic localized pulmonary brucellosis. JAMA 161:1044–1047

    CAS  Google Scholar 

  23. Yagupsky P, Baron EJ (2005) Laboratory exposures to Brucellae and implications for bioterrorism. Emerg Infect Dis 11:1180–1185

    PubMed  Google Scholar 

  24. Yavuz T, Ozaydin M, Ulusan V, Ocal A, Ibrisim E, Kutsal A (2004) A case of mitral stenosis complicated with seronegative Brucella endocarditis. Jpn Heart J 45:353–358

    Article  PubMed  Google Scholar 

  25. Young EJ (1997) Brucellosis. In: Connor DH, Chandler FW, Schwartz DA, Manz HJ, Lack EE (eds) Pathology of infectious diseases. Appleton & Lange, Stamford, pp 447–452

    Google Scholar 

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Author notes

  1. Heinrich Neubauer

    Present address: Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Naumburger Strasse 96a, 07743, Jena, Germany

  2. Sascha Al Dahouk

    Present address: Department of Internal Medicine III, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

Authors and Affiliations

  1. Institute of Pathology and Neuropathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany

    Dirk Theegarten & Martin Tötsch

  2. Department of Pneumology, Ruhrlandklinik, University Hospital Essen, Tueschener Weg 40, 45239, Essen, Germany

    Sven Albrecht & Helmut Teschler

  3. Department of Bacteriology, Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, 80937, Muenchen, Germany

    Heinrich Neubauer & Sascha Al Dahouk

Authors
  1. Dirk Theegarten
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  2. Sven Albrecht
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  3. Martin Tötsch
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  4. Helmut Teschler
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  5. Heinrich Neubauer
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  6. Sascha Al Dahouk
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Correspondence to Dirk Theegarten.

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Theegarten, D., Albrecht, S., Tötsch, M. et al. Brucellosis of the lung: case report and review of the literature. Virchows Arch 452, 97–101 (2008). https://doi.org/10.1007/s00428-007-0518-0

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  • DOI: https://doi.org/10.1007/s00428-007-0518-0

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