Congenital brucellosis: a case report

Abstract Background Brucellosis is the most common zoonotic infection worldwide, and is caused by bacterial genus Brucella. The disease is rarely transmitted via human-to-human transmission. Few cases have been reported about vertical transmission of human brucellosis. Herein, we reported a case of congenital brucellosis, with clear evidence of pathogen detected in mother’s placental specimen. Case presentation: A 34-day-old girl was admitted to the department of pulmonology with fever for eight days. Three blood samples and one sample of cerebrospinal fluid were positive for Brucella melitensis. The diagnosis of brucellosis and Brucella melitensis meningitis were established, along with hyperbilirubinemia and liver dysfunction. Treatment of rifampicin (for six weeks) and meropenem (for two weeks) was administered. However, the disease relapsed within 18 days. Thereafter, a combination therapy of rifampicin and SMZ/TMP was administered for eight weeks. The disease relapsed again in 42 days. For chronic brucellosis, three courses of combination therapy of rifampicin and SMZ/TMP was administered. The mother had fatigue and arthralgia for two weeks, fever and membrane rupture one day before the baby was born. Brucella melitensis DNA was detected in the mother’s placental specimen by next-generation sequencing and bacterial identification under microscope proved chorioamnionitis. Conclusions We reported a confirmed case of congenital brucellosis. This disease should be closely monitored even in non-epidemic areas. The treatment of brucellosis in infancy faces challenges of drug choice and disease relapse.