Abstract
Rickettsia is the pathogen of Q fever, Brucella ovis is the pathogen of brucellosis, and both of them are Gram-negative bacteria which are parasitic in cells. The mixed infection of rickettsia and Brucella ovis is rarely reported in clinic. Early diagnosis and treatment are of great significance to the treatment and prognosis of brucellosis and Q fever. Here, we report a case of co-infection Rickettsia burneti and Brucella melitensis. The patient is a 49-year-old sheepherder, who was hospitalized with left forearm trauma. Three days after admission, the patient developed fever of 39.0°C, accompanied by sweating, fatigue, poor appetite and headache. Indirect immunofluorescence (IFA) was used to detect Rickettsia burneti IgM. After 72 hours of blood culture incubation, bacterial growth was detected in aerobic bottles, Gram-negative bacilli were found in culture medium smear, the colony was identified as Brucella melitensis by mass spectrometry. Patients were treated with doxycycline (100 mg bid, po) and rifampicin (600 mg qd, po) for 4 weeks. After treatment, the symptoms disappeared quickly, and there was no sign of recurrence or chronic infection. Q fever and Brucella may exist in high-risk practitioners, so we should routinely detect these two pathogens to prevent missed diagnosis.
Highlights
Brucella melitensis is the pathogen of brucellosis, and Rickettsia burneti is the causative agent of Q fever, both of which are intracellular parasitic Gram-negative bacteria
Human infection may occur due to inhalation of dust contaminated by body fluids of infected animals, consumption of unpasteurized dairy products and contact with milk, urine, feces, vaginal mucus or semen of infected animals [7]
The clinical manifestations of Q fever were non-specific and 60% asymptoms, which may cause a large number of misdiagnosis and missed diagnosis
Summary
Brucella melitensis is the pathogen of brucellosis, and Rickettsia burneti is the causative agent of Q fever, both of which are intracellular parasitic Gram-negative bacteria. In the past three months, he has delivered sheep several times He lives in Tianmen, Hubei Province, China, where there is no epidemic history of Rickettsia and Brucella. Routine laboratory tests showed that there was no obvious abnormality in white blood cell (WBC), liver and kidney function, or coagulation function. Considering his direct contact with sheep, respiratory pathogens were detected by IFA, including Legionella pneumophila IgM, Mycoplasma pneumoniae IgM, Rickettsia burgdorferi IgM, Chlamydia pneumoniae IgM, adenovirus IgM, respiratory syncytial virus IgM, influenza A virus IgM, influenza B virus IgM and parainfluenza virus IgM. After 72 hours blood incubation, bacterial growth was detected in aerobic bottles, and the culture medium was extracted and inoculated in Columbia blood plate and chocolate plate without vancomycin, and placed
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