Brucellosis is an infection found worldwide, the incidence of which has diminished in recent years in France. The authors report a retrospective study on 59 cases of brucellosis occuring between 1980 and 1996 in the University hospitals of Bordeaux, in internal medicine, infections diseases, and rhumatology units. Fifty-nine patients (45 men, 14 women) mean age 44 years (7 to 83), were diagnosed with brucellosis. 68 % had a predisposing factor (risk profession, consumption of dairy products). 31 presented an acute form with fever that tended to be irregular and vesperal (31), sweating (25), marked asthenia (16), weight loss (9), arthralgias (9), splenomegaly (7), and/or hepatomegaly (6). 26 had a localized form, mainly osteoarticular (10 spondylitis with discitis, 5 coxitis, 4 sacroiliitis, 1 arthritis of the knee, 1 arthritis of the ankle), but also genital (1 orchitis, 1 salpingitis), cardiac (1 endocarditis, I myocarditis), neurological (1 meningoencephalitis), and splenic (1 patient had multiple splenic abscesses). Two patients presented clinical signs consistent with a chronic brucellosis. Moderate hepatitis was noted in 29. Blood cultures were positive in 23, 10 among the localized forms (B. melitensis 10 cases, B. abortus 3 cases, B. suis 2 cases, 8 cases remained unidentified). The pathogen was isolated 8 times by guided specimen collection. Serologic tests were positive in all cases. The melitin skin test was positive in both patients presenting a chronic form. Treatment mainly relied upon the association of rifampin and doxycycline. Seven patients were managed by monotherapy (ofloxacin or doxycycline). Fever subsided an average of 7 days after beginning treatment (from 2 to 30 days), hepatic cytolysis in less than a month, while a low neutrophil count sometimes persisted up to 3 months. Eight patients initially presenting an acute form underwent a localized relapse.
Neau, D., Bonnet, F., Ragnaud, J. M., Pellegrin, J. L., Schaeverbeke, T., Monlun, E., … Le Bras, M. (1997). Etude retrospective de 59 cas de brucellose humaine en aquitaine. Aspects cliniques, biologiques et therapeutiques. Medecine et Maladies Infectieuses, 27(SPEC. ISS. JUNE), 638–641. https://doi.org/10.1016/S0399-077X(97)80215-6