minocycline and Brucellosis

A 35-year-old man presented a case of recurrent episcleritis revealing brucellosis. No concurrent diagnosis other than brucellosis could account for the episcleritis. Moreover his status was dramatically improved by specific antibiotherapy. A review of the literature showed that uveitis and optic neuropathies are the most common ocular manifestations of brucellosis. To the best of our knowledge, this is the first case of episcleritis associated with brucellosis.

Topics: Adult; Anti-Bacterial Agents; Brucellosis; Enzyme Inhibitors; Follow-Up Studies; Humans; Male; Minocycline; Recurrence; Rifampin; Scleritis

Involvement of the renal parenchyma in the acute phase of brucellosis is very rare. Only two cases of renal brucelloma have been reported in the English language literature to date. We report a case of renal abscess caused by Brucella in the acute phase. A 45-year-old Chinese man presented with a high fever, urine occult blood, and a low density lesion in the right kidney. Ultrasound-guided aspiration was done. Brucella melitensis was isolated from both blood and puncture fluid culture. Minocycline combined with moxifloxacin was prescribed for 4 months. The infection relapsed at 6 months after discontinuation. Minocycline combined with rifampin was administered for another 2 months. The brucellosis had not relapsed at more than 20 months later. It is possible to cure renal brucelloma with antibiotics and ultrasound-guided aspiration. Treatment should not be discontinued until the abscess has disappeared and two consecutive blood cultures taken 1 month apart are negative.

Topics: Abscess; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Drug Therapy, Combination; Fluoroquinolones; Humans; Kidney Diseases; Male; Middle Aged; Minocycline; Moxifloxacin; Rifampin

Brucellosis is one of the most common systemic zoonotic diseases transmitted by consumption of unpasteurized dairy products or by occupational contact with infected animals. Brucellosis is rare in renal transplant recipients. Only 3 cases have been reported in the literature. We report a case of brucellosis with hematologic and hepatobiliary complications in a patient 3 years after renal transplantation. The mean time from transplantation to the diagnosis of brucellosis in these 4 reported patients was 5.1 years (range 17 months to 13 years). All patients had fever and constitutional symptoms, and all attained clinical cure after combination antibiotic therapy. Given the small number of patients, further study is needed to identify the characteristics of brucellosis in renal transplant recipients. Drug interactions and acute renal failure developed in our patient during antibiotic treatment. Therefore, we should monitor the levels of immunosuppressive agents frequently. Several studies have shown in vitro susceptibilities of Brucella melitensis to tigecycline. In our patient, fever finally subsided after tigecycline administration. The minimum inhibitory concentration of tigecycline using Etest was 0.094 μg/mL. Tigecycline may be a potential option for treatment of brucellosis in the setting of transplantation.

Topics: Animals; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Drug Therapy, Combination; Humans; Immunosuppressive Agents; Kidney; Kidney Transplantation; Male; Middle Aged; Minocycline; Tigecycline; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Zoonoses

Brucellosis is a worldwide zoonotic disease and still constitutes a major public health problem. In the study we claimed to identify Brucella species from clinical samples of patients with active brucellosis from Van region of Eastern Anatolia and to determine in vitro antimicrobial susceptibilities of these strains to commonly used anti-Brucella agents and a possible new alternative tigecycline.. A total of 56 Brucella isolates were enrolled the study and the identification of the isolates were based on conventional methods. In vitro activities of antimicrobials were evaluated by the E test method.. All isolates were identified as B. melitensis. MIC(90) values of doxycycline, streptomycin, rifampin, trimethoprim-sulfamethoxazole and tigecycline were 0.064 mg/L, 1 mg/L, 2 mg/L, 0.125 mg/L and 0.094 mg/L, respectively. Tigecycline had low MIC(50) and MIC(90) values against all B. melitensis strains; the highest MIC observed was 0.25 μg/mL.. Our data suggest that tigecycline can be a therapeutic alternative option for the treatment of brucellosis.

Topics: Anti-Bacterial Agents; Brucella; Brucella melitensis; Brucellosis; Doxycycline; Humans; Microbial Sensitivity Tests; Minocycline; Rifampin; Streptomycin; Tigecycline; Trimethoprim, Sulfamethoxazole Drug Combination; Turkey

Brucellosis is a zoonosis with a worldwide distribution and remains a significant public health problem mainly in the developing world. In this study we evaluated the in vitro activities and synergistic effects of antibiotic combinations against blood culture isolates of Brucella spp. In vitro susceptibilities of 76 blood culture isolates of Brucella melitensis and one blood culture isolate of Brucella abortus to doxycycline, streptomycin, gentamicin, trimethoprim-sulfamethoxazole, moxifloxacin, rifampin, ciprofloxacin, and tigecycline were examined by Etest method. For 37 patients with Brucella spp. isolates (36 B. melitensis, 1 B. abortus), antibiotic combinations used for treatment were identified with those tested in vitro for synergy using Etest method. Trimethoprim-sulfamethoxazole and tigecycline were the most active of the compounds tested with MIC90 value of 0.094 mg/l. Among antibiotic combinations only streptomycin-rifampin combination was synergistic for one Brucella spp. isolate. The other antibiotic combinations revealed antagonistic or indifferent activity. Complete clinical response was achieved in all patients. Further studies are required to determine the correlation between the antimicrobial susceptibility and synergy test results with the clinical course of patients. Brucellosis can be adequately treated with existing regimens in our region.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Brucella; Brucellosis; Child, Preschool; Drug Synergism; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Minocycline; Tigecycline

Topics: Adult; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Carcinoma, Hepatocellular; Graft Rejection; Hepatitis C; Humans; Liver Failure; Liver Neoplasms; Liver Transplantation; Male; Minocycline; Reoperation; Tigecycline; Treatment Outcome

Brucellosis is a major zoonotic disease of global importance. Forty years after active drug therapy was defined, there is no optimum antibiotic therapy for brucellosis due to relatively high rates of relapse and treatment failure. The aim of this study was to assess the in vitro susceptibility of 60 Brucella melitensis isolates obtained from blood and fluids to tigecycline, tetracycline and three quinolones (ciprofloxacin, levofloxacin, moxifloxacin). The minimum inhibitory concentrations (MICs) of these antibiotics were determined by E-test method. According to the MIC90, levofloxacin (MIC90 0.094 microg/mL) was found to be the most active agent, followed by tigecycline (MIC90 0.125 microg/mL), moxifloxacin (MIC90 0.125 microg/mL), ciprofloxacin (MIC 90 0.19 microg/mL) and tetracycline (MIC90 0.25 microg/mL). The results suggest that tigecycline can be a therapeutic alternative option for the treatment of brucellosis.

Topics: Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Fluoroquinolones; Humans; In Vitro Techniques; Microbial Sensitivity Tests; Minocycline; Tetracycline; Tigecycline; Turkey

Topics: Adult; Anti-Bacterial Agents; Brucella; Brucellosis; Ciprofloxacin; Doxycycline; Humans; Microbial Sensitivity Tests; Minocycline; Rifampin; Tigecycline

The in vitro efficacy and synergistic activity of tigecycline in comparison with other antimicrobials used in brucellosis, were tested for 16 Brucella melitensis strains by the E-test method. Tigecycline had the lowest minimal inhibitory concentration levels, and rifampin the highest, in the study. Tigecycline also provided the better synergistic activity compared to doxycycline according to the fractional inhibitory concentration index. The results of this in vitro study suggest tigecycline as a therapeutic alternative for brucellosis. These observations need to be supported with clinical studies.

Topics: Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Doxycycline; Drug Synergism; Drug Therapy, Combination; Humans; Microbial Sensitivity Tests; Minocycline; Rifampin; Streptomycin; Tigecycline

Forty-one children <8 years of age treated for brucellosis with oral minocycline (2.5 mg/kg) twice daily for 3 weeks were recalled and examined to check for dental staining and defects. Dental staining and defects were found in 14 of 41 exposed children (34.1%) and in 30 of 82 matched controls (36.6%), respectively (P > 0.2).

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Brucellosis; Child; Child, Preschool; Dental Enamel; Humans; Minocycline; Retrospective Studies; Rifampin; Tooth Diseases

In order to evaluate the efficacy and tolerability of a high intravenous dose of rifampin plus oral minocycline (administered daily for 3 weeks) for the treatment of acute brucellosis, we retrospectively reviewed the outcome of 239 consecutive patients (135 adults and 104 children) diagnosed and treated over a 17-year period in Italy. The combination used resulted in 100% response and a relapse rate lower than 2%. Fifty-two (30 adults and 22 children) (29.8%) complained of mild adverse effects including an increase in aspartate aminotransferase (>250 IU) observed in 12 cases and considered related to rifampin and in 11 cases a reversible hyperpigmentation of the tongue attributed to minocycline. A randomized prospective comparative study should be performed to confirm our encouraging results.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Brucella; Brucellosis; Child; Child, Preschool; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Infusions, Intravenous; Italy; Male; Middle Aged; Minocycline; Recurrence; Retrospective Studies; Rifampin; Risk Assessment; Treatment Outcome

The authors report bilateral papilledema in a 14 year old boy with brucellosis. Papilledema disappeared completely about one month after the clinical recovery of brucellosis, treated with rifampicin and minocicline, without associated steroids or non steroidal anti-inflammatory drugs.

Topics: Adolescent; Brucellosis; Fluorescein Angiography; Fundus Oculi; Humans; Male; Minocycline; Papilledema; Rifamycins

After a brief review of the literature on the treatment of brucellosis the results obtained with a new protocol (Rifampicin + Minocycline for 20 days) are reported. The combination was well-tolerated and undeniably effective producing a 94% cure rate.

Topics: Adolescent; Adult; Aged; Brucellosis; Child; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Male; Middle Aged; Minocycline; Rifampin; Tetracyclines; Time Factors

295 cases of acute and subacute cases of brucellosis were treated with minocycline. It is concluded that because of its in vitro activity, its penetrability in macrophages and granulomas and its tolerance, minocycline is the antibiotic of choice for brucellosis.

Topics: Adolescent; Adult; Aged; Brucellosis; Child; Child, Preschool; Doxycycline; Female; Humans; Infant; Male; Middle Aged; Minocycline; Recurrence; Tetracyclines

The authors report a case presenting with a very rare localization of brucellosis: the isolated involvement of a single bone of the metatarsus, in a child in otherwise excellent general condition. The lesions of the diaphysis and epiphyses induced a fragility of the epiphyseal cartilage and a minimal traumatism resulted in a detachment of the epiphysis which was the first clinical sign. The bacteriological examination of a sample of pus led to the early diagnosis of brucellosis, therefore allowing efficient treatment.

Topics: Brucella; Brucellosis; Child; Humans; Male; Metatarsus; Minocycline; Osteitis; Rifampin

Topics: Anti-Bacterial Agents; Brucellosis; Humans; Minocycline; Rifampin; Streptomycin; Sulfamethoxazole; Trimethoprim

Slide agglutination and mercaptoethanol tube agglutination tests for canine brucellosis were performed on 158 dogs. Clinical status was compared with the serologic test results. Sera were from 56 clinically normal dogs, 63 dogs with reproductive disorders, and 39 dogs with various nonreproductive disorders that could be associated with canine brucellosis. Ten of 21 (48%) aborting bitches and 2 of 9 (22%) bitches with other reproductive disorders were seropositive for brucellosis. Enlarged testicles, orchitis, and epididymitis were the main clinical disorders associated with positive (33%) or suspect (20%) serologic reactions in 15 male dogs. In 13 dogs of both sexes, diskospondylitis and osteomyelitis were the most common nonreproductive disorders associated with seropositive status for canine brucellosis (46%). Of 138 stray dogs, 17 were seropositive for canine brucellosis. Treatment of seropositive animals with antibiotics gave variable results. Of the 296 serum samples tested, 43 (14.5%) gave a positive reaction by the slide agglutination test but were negative by the mercaptoethanol tube agglutination test. Correlation was not found between serologic results and sex or breed.

Topics: Abortion, Veterinary; Agglutination Tests; Animals; Brucellosis; Dog Diseases; Dogs; Female; Infertility; Male; Minocycline; Pregnancy; Tetracycline

Topics: Brucellosis; Drug Therapy, Combination; Humans; Minocycline; Rifampin; Tetracyclines

Topics: Adolescent; Adult; Age Factors; Brucellosis; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male; Middle Aged; Minocycline; Tetracyclines; Time Factors