EID, 2023
症例1: 39歳男性（ブラジルベレン出身：内密の金採掘者）。2020年9月に発熱、虚弱、下部背部痛、肝脾腫、軽度貧血、炎症反応軽度高値、肝酵素上昇。CTRX→TAZ/PIPC、血液培養採取後68時間で陽転化（質量分析でB.melitensis）→DOXY, RFP, GM。心エコーではIEの所見なし。殺菌していない乳製品は摂取は否定も、野生のブタ肉などの狩猟での摂食を明かした。治療6週間（フォローアップでは来院せず）
症例2: ４５歳男性、不法の金採掘者。2020年10月に発熱、下部背部痛、10か月で8kgの体重減少。軽度貧血、炎症反応高値。画像でL4/L5に椎体炎、腸腰筋膿瘍の所見。エンピリックな結核治療後に6日でB.melitensisを同定。DOXY, RFP, GM治療。森林で狩猟の肉を食べたと報告。フォローアップでは来院せず
→2つの菌株について再同定精査。B.melitensisを含め既存の菌種とは遺伝子的に相違があることを確認し、新種感染と確定。
Abstract
Human brucellosis is a zoonoses caused by bacteria of the genus Brucella. Infection results in subacute or chronic debilitating disease with nonspecific clinical manifestations and is often associated with consuming unpasteurized dairy products. We report 2 cases of brucellosis in male patients who were hospitalized in distinct towns of French Guiana, an overseas territory of France located on the northeastern shore of South America. Both men were citizens of Brazil working as clandestine goldminers in the deep Amazonian rainforest. Characterization of the 2 bacterial isolates revealed that they represent a potential new species of Brucella. Medical practitioners working in contact with wildlife in this region of the world should be aware of the existence of these pathogens and the potential for human infection.
ブルセラ症（国立感染症研究所2021）
https://www.niid.go.jp/niid/ja/kansennohanashi/513-brucella.html
