人 Brucella melitensis 感染症の病性鑑定報告

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  • Diagnosis Report of Human Brucellosis caused by Brucella melitensis in Japan
  • ヒト Brucella melitensis カンセンショウ ノ ビョウセイ カンテイ ホウコク

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In Japan, brucellosis has been very rare not only in human but also in animals except dogs for a long time, although it was prevalent among cattle before 1965. In 1998, four bacterial strains suspected to be a member of genus Brucella were submitted from Metropolitan Komagome Hospital to National Institute of Animal Health for the identification of the species. Three were isolated from a man and one was from his wife, who manifested sickness with undulant fever, swelling of liver and spleen, and arthritis. They had visited Iraq shortly before becoming ill. The identification of these isolates was impossible with commercially available kits. Identification was done by Gram staining, slide-glass agglutination test with anti-smooth type Brucella serum and anti-rough type Brucella serum, colonial morphology, growth on selective agar medium, requirement of carbon dioxide for growth, growth on agar medium containing thionin and basic fuchsin, growth on selective agar medium, production of hydrogen sulfide, lysis with Weybridge-phage, and slide-agglutination test with monospecific antisera against A and M. These isolates were also examined by PCR specific to Brucella abortus, B. melitensis, and biotypes 1 and 5 of B. suis. From these characteristics, all isolates were identified as B. melitensis biotype 2. Five serum samples collected from the patients at intervals of 2 to 3 weeks were also submitted for the measurement of antibody titer against Brucella species. The tube agglutination titers of all five sera were between 400 IU and 800 IU and were greater than the threshold titer of 160 IU. The complement fixing titers were between 256 IU and 1,024 IU and also greater than the threshold titer of 16 IU. From these results their illness were diagnosed as brucellosis caused by B. melitensis biotype 2.

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