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• W2768162286 abstract "A 27-year old microbiologist developed rash, chills, sweating, fatigue, joint pain, nosebleed, headache and undulating fever. Two months ago, he accidently got exposed to Brucella melitensis cultures. Inflammation parameters and aminotransferases were moderately elevated. Serological tests showed presence of Brucella specific antibodies, and Brucella melitensis was cultured from blood. An acute brucellosis as a laboratory infection was diagnosed. This infection route is feared in microbiological laboratories because the airborne infection dose of Brucella cultures is extremely low (Neubauer, 2010Neubauer H. Brucellosis: new demands in a changing world.Prilozi. 2010; 31: 209-217PubMed Google Scholar, Pappas et al., 2006Pappas G. Panagopoulou P. Christou L. et al.Brucella as a biological weapon.Cell Mol Life Sci. 2006; 63: 2229-2236Crossref PubMed Scopus (176) Google Scholar). Three days after initiation of antibiotic treatment with doxycycline and rifampicin, the patient presented at the emergency room with a dull retrosternal pain and cold sweat. Laboratory parameters revealed a strongly elevated troponin T level (1246 pg/ml). Chest X-ray, electrocardiogram and echocardiography were unsuspicious. Contrast-enhanced cardiac MRI revealed a marked subepicardial hyperintensity in T2 weighted imaging compatible with edema (Figure 1) and a pattern of myocardial delayed enhancement in the mid anterolateral wall (Figure 2), thus indicating a myocarditis suspected of Brucella. This potentially lethal complication is highly rare, particularly in the absence of simultaneous endocarditis (Abid et al., 2012Abid L. Frikha Z. Kallel S. et al.Brucella myocarditis: a rare and life-threatening cardiac complication of brucellosis.Intern Med (Tokyo, Japan). 2012; 51: 901-904Crossref PubMed Scopus (10) Google Scholar).Figure 2a, b: The cardiac MRIs show a pattern of myocardial delayed enhancement in the mid anterolateral wall, thus indicating a myocarditis.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Due to the myocardial complication, gentamicin was added for 10 days along with a prolonged, 12-week antibiotic therapy with doxycycline and rifampicin, although the evidence for this enforcement of antibiotic therapy is sparse (Gatselis et al., 2011Gatselis N.K. Makaritsis K.P. Gabranis I. et al.Unusual cardiovascular complications of brucellosis presenting in two men: two case reports and a review of the literature.J Med Case Rep. 2011; 5: 22Crossref PubMed Scopus (18) Google Scholar). After several months of physical rest and rehabilitation, the patient recovered completely. Conflict of interest statement: No conflict of interest; no funding." @default.
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• W2768162286 date "2018-01-01" @default.
• W2768162286 modified "2023-10-06" @default.
• W2768162286 title "Brucella related myocarditis" @default.
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• W2768162286 doi "https://doi.org/10.1016/j.ijid.2017.11.014" @default.
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