Abstract
BackgroundBrucellosis is a chronic bacterial disease caused by members of the genus Brucella. Among the classical species stands Brucella neotomae, until now, a pathogen limited to wood rats. However, we have identified two brucellosis human cases caused by B. neotomae, demonstrating that this species has zoonotic potential.Cases presentationWithin almost 4 years of each other, a 64-year-old Costa Rican white Hispanic man and a 51-year-old Costa Rican white Hispanic man required medical care at public hospitals of Costa Rica. Their hematological and biochemical parameters were within normal limits. No adenopathies or visceral abnormalities were found. Both patients showed intermittent fever, disorientation, and general malaise and a positive Rose Bengal test compatible with Brucella infection. Blood and cerebrospinal fluid cultures rendered Gram-negative coccobacilli identified by genomic analysis as B. neotomae. After antibiotic treatment, the patients recovered with normal mental activities.ConclusionsThis is the first report describing in detail the clinical disease caused by B. neotomae in two unrelated patients. In spite of previous claims, this bacterium keeps zoonotic potential. Proposals to generate vaccines by using B. neotomae as an immunogen must be reexamined and countries housing the natural reservoir must consider the zoonotic risk.
Highlights
Brucellosis is a chronic bacterial disease caused by members of the genus Brucella
This is the first report describing in detail the clinical disease caused by B. neotomae in two unrelated patients
Rare Brucella isolates have been reported in human cases, including some strains similar to those isolated from marine mammals [2,3,4]
Summary
Physicians should consider brucellosis caused by B. neotomae as one of the agents for human disease. Even in those areas where Brucella organisms have been eradicated from domestic animals, B. neotomae may still be a zoonotic risk. The fact that B. neotomae is capable of invading the brain indicates the robust pathogenic potential of B. neotomae. Differential diagnosis with other diseases that present with intermittent fever is necessary, whether they are in endemic or non-endemic areas. Abbreviation MLVA16: Multiple-locus variable number tandem repeat analysis of 16 sequences
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