Brucella melitensis sternal osteomyelitis following median sternotomy

J Infect Chemother. 2014 Sep;20(9):574-6. doi: 10.1016/j.jiac.2014.04.011. Epub 2014 Jun 6.

Abstract

Human brucellosis, a zoonotic infection, may present with a range of symptoms but is rarely described as a cause of surgical site infections. We present the first reported case of Brucella melitensis causing sternal osteomyelitis of a midline sternotomy for a coronary artery bypass graft. The operation was performed in a non-endemic country but the patient had travelled to Syria immediately before surgery, where the infection was assumed to have been acquired. The infection resolved following treatment with doxycycline, rifampicin and gentamicin. We review the literature for surgical site infections related to Brucella species and discuss the infection control implications. Human brucellosis has the potential to cause surgical site infections and it should be in the differential diagnosis of any patient with a relevant exposure history presenting with a febrile illness and musculoskeletal findings.

Keywords: Brucella melitensis; Brucellosis; Osteomyelitis; Sternotomy; Surgical site infection.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Brucella melitensis / drug effects
  • Brucella melitensis / isolation & purification*
  • Brucellosis / drug therapy
  • Brucellosis / microbiology*
  • Female
  • Humans
  • Middle Aged
  • Osteomyelitis / drug therapy
  • Osteomyelitis / microbiology*
  • Sternotomy / adverse effects*
  • Sternotomy / methods

Substances

  • Anti-Bacterial Agents