brucella-symptoms

bjorn.osterman at alinks.se bjorn.osterman at alinks.se
Mon Jun 12 06:49:32 EST 1995


     Dear Jennifer,
     What you are describing concerning your co-worker does fit very well 
     with the clinical picture of brucellosis, now with special reference 
     to chronic brucellosis. The diagnosis of brucellosis in the case of 
     your co-worker is evidently absolute with positive Brucella-cultures 
     from blood, bone marrow, and liver biopsy.
     
     There are many descriptions like yours in literature. But you must go 
     back some decades to find penetrative, relevant clinical histories. I 
     will recommend you to look in the library for Wesley W. Spink (1956, 
     "The Nature of Brucellosis") and Sir Weldon Dalrymple-Champneys (1960, 
     "Brucella Infection and Undulant Fever in Man"); these authors have 
     made massive contributions to the knowledge of brucellosis.
     
     There is a similar and outstanding case in history, and I am referring 
     to the case of Dr Alice Evans, the microbiologist who proved (in 1918) 
     the Micrococcus of Malta fever (David Bruce) to be a gramnegative rod 
     and to be very closely related to the organism of contagious abortion 
     of cattle (Bernhard Bang). Dr Evans suffered from brucellosis during 
     several years (contracted in 1922 from experiments with B.melitensis). 
     She is describing a medical illness, full of misunderstandings from 
     colleagues in the direction of Dr Evans having 'neurasthenia' or other 
     neuropsychiatric disorder; she was hospitalized for several periods of 
     time. Ultimately (by accident) her diagnosis was evidenced by positive 
     culure for Brucella (during operation, caused by another disease). 
     Look for Alice Evans: "Chronic Brucellosis" (JAMA, 1934), "Brucellosis 
     in the Untied States" (Am. J. Publ. Hlth, 1947).
     
     Jennifer, I do find your story extremely interesting. Keep in touch, 
     if you think there is something I can do to help you. Perhaps it is 
     worthwile once more to make a thourough clinical investigation of your 
     co-worker, including cultures for Brucella. Perhaps one shall take 
     into account a once-more-period of heavy antibiotic therapy (large 
     doses for a long period of time, presumably combined rifampicin and 
     doxycycline). 
     
     Address:                           Best regards,
     SMCL/Bakt                                       Yours sincerely
     PO Box 6401
     Sabbatsbergs Hospital                           Bj|rn Osterman, MD
     S-113 82 SSTOCKHOLM
     SWEDEN                             fax: +46-8-302577



______________________________ Reply Separator _________________________________
Subject: brucella-symptoms
Author:  SE {HEQZ65A at prodigy.com}
Date:    1995-06-11 9.58


Hi, my name is Jennifer.  I have a co-worker who has suffered from 
brucellosis and her insurance company refuses to believe that her present 
discomforts are due to this illness.  I wonder if anyone out there knows 
about symptoms that occur when brucella goes untreated for a short period 
of time.
     In April of 1988, she began experiencing gastic distress, swollen
joints, chills, fever, lethargy, decreased blood pressure, and elevated 
liver enzymes.  She was admitted to the hospital with a diagnosis of Non 
A-Non B hepatitis and was treated.
     October of 1988, a febrile agglutinin serum blood test was performed
and she demonstrated an abnormally elevated titer to brucella.  At this 
time, many fellow employees in my department (Microbiology) also were 
experiencing milder symptoms along with elevated titers.  Her diagnosis 
was then changed to Brucellosis which was further evidenced by obtaining 
positive results on the liver biopsy, bone marrow, and blood cultures. 
The infection had progressed to such an extent that the intial treatment 
failed and a secondary course of treatment had to begin.  The source of 
the infection was later determined to be an accidental exposure to 
brucella.
     During this lengthy illness, she experienced tremors, inability to
walk, sit, stand, or sleep for any length of time.  In late 1989, she was 
referred to a psychiatrist for severe depression and was unable to work. 
Her depression further progressed to a point where the only therapy given 
was shock treaments.  She returned to work on a part-time basis and has 
progressed to her present level. ]
     She still is not in perfect health.  She suffers from Chronic
Fatigue Syndrome, Polymyalgia Rheumatica, and constant pain.  She also 
has trouble sleeping due to decreased serotonin levels.  Medical 
literature in the United States only shows several of her symptoms.  I
wonder if anyone knows about this illness and can tell me more about it... 
Thank You!
     
Jen
  
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