This case report reviews an infectious disease caused by bacteria,
This report is on clinical human Brucellosis that occurred in Malaysia.
The individual affected was a 29-year-old lady, a research laboratory assistant
who worked in a veterinary microbiological laboratory in Malaysia. In the past
3 months, she and 9 other laboratory workers were involved in a research
isolation of B. melitensis from goats, because of the occupational exposure to
this infected animal that was used for this research, she got infected with
Brucellosis (Hartady et al., 2014).
However, in Malaysia, studies have shown seropositive humans that were
infected with Brucellosis, and 90% was mainly in males within the age range of
20-45 years old, even though clinical human Brucellosis is still rare,
seroconverts are relatively more in Malaysia (Hartady et al., 2014).
For three days she complained of intermittent fever, anorexia, malaise,
headaches, profuse sweating, and muscle pain in the neck and shoulder. The next
day, she was admitted to the clinic for dengue and malaria blood test, but the
result was negative, after the negative test result, the clinic suspected the
common flu was the reason for the symptoms she was having and prescribed
vitamin C, paracetamol, and cough syrup but the symptoms persisted for one
month and it got worse (Hartady et al., 2014). This means that the clinic
experienced difficulty figuring out what the sickness was and guessed-treated
her. However, at this point, I wonder if she was asked by the doctor for
previous exposure to animals of any sort during her first doctors visit?
knowing that she worked in a laboratory as a research assistant.
Further, into this health challenge, she started having anemia,
hypotension, and lost a lot of body weight from 50 kg to 42kg, then she got
admitted back into the hospital and abdominal palpitation checks were done and
it revealed she had hepatomegaly and splenomegaly with extreme pain. After
other test results on her blood levels and blood cells were conducted, it
showed that her hemoglobin, hematocrit, and neutrophil were low while the
lymphocytes and erythrocyte sedimentation rate were high during the first month
of infection. (Hartady et al., 2014)
At this moment, based on the history of her previous exposure and
handlings of both organisms and the persistent and worsening symptoms she was
experiencing, the doctors suspected it to be either leptospirosis or
brucellosis. Then the Rose-Bengal plate test was performed using the B.
melitensis antigen which showed a level of high antibody. After 14 days, the
test was repeated, and it still showed high antibody level against Brucella.
After this, a diagnosis of brucellosis was made, then she was correctly
prescribed the right drugs for treatment which was rifampicin p.o. and
doxycycline p.o. Rifampicin p.o. was to be taken once a day combined with the
doxycycline p.o. taken twice a day for 6 consecutive weeks before she started
recovering fully (Hartady et al., 2014).
To prevent this fatal disease from occurring in humans, starting with
those who handle animal tissues, they should correctly protect themselves from
animals that have been infected with bacteria, to avoid it getting into their eyes,
cut on the skin or abrasion on the skin by wearing goggles, gowns, and aprons,
and rubber gloves (Center for Disease Control and Prevention, 2012). Also, for
those who consume poultry and animal proceeds, they need to ensure the meat is
well prepared with no form of redness, and ensure the raw milk consumed is well
pasteurized i.e. heating to a high temperature for a short time which helps
keep the milk safe to consume by killing harmful bacteria (CDC, 2012).
Center for Disease Control and Prevention. (2012).
Brucellosis. Atlanta, GA: U.S. Government Printing Office. Retrieved from https://www.cdc.gov/brucellosis/index.html
Hartady, T., Saad, M. Z., Bejo, S. K.,
& Salisi, M. S. (2014). Clinical human brucellosis in Malaysia: a case
report. Asian Pacific Journal of Tropical Disease, 4(2),
150–153. http://doi.org/10.1016/S2222-1808(14)60332-7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032053/