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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