Brucellosis revealed via persistent urinary tract infection

https://doi.org/10.53730/ijhs.v10n2.15900

Authors

  • Elda Skenderi University Hospital Center “Mother Teresa”, Tirana, Albania
  • Artemisi Shehu Dono University of Tirana, Faculty of Social Sciences, Tirana, Albania
  • Gjeorgjina Kuli-Lito University Hospital Center “Mother Teresa”, Tirana, Albania
  • Alberta Shkembi University Hospital Center “Mother Teresa”, Tirana, Albania

Keywords:

Adolescent, Brucellosis, Non-specific, Persistent, Urinary tract infection

Abstract

Urinary tract infection is common in children. Bacterial infections are the most common cause of it. Pyuria is sensitive but nonspecific in making a diagnosis, urine culture is the criterion standard. Persistent urinary tract infection associated with fever is a very concerning finding in pediatric patients. Here is reported the case of an adolescent , in whom the persistence of fever with pyuria arouse suspicion towards Brucellosis. Brucellosis in children is associated with non-specific symptoms. It is a systemic disease which may be presented with focal symptoms of any organ system, including urinary tract. 

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References

Barquero-Calvo, E., Chaves-Olarte, E., Weiss, D. S., Guzman-Verri, C., Chacon-Diaz, C., Rucavado, A., ... & Moreno, E. (2007). Brucella abortus uses a stealthy strategy to avoid activation of the innate immune system during the onset of infection. PloS one, 2(7), e631.

Bellaire, B. H., Elzer, P. H., Hagius, S., Walker, J., Baldwin, C. L., & Roop, R. M. (2003). Genetic organization and iron-responsive regulation of the Brucella abortus 2, 3-dihydroxybenzoic acid biosynthesis operon, a cluster of genes required for wild-type virulence in pregnant cattle. Infection and immunity, 71(4), 1794-1803.

Chu, C. M., & Lowder, J. L. (2018). Diagnosis and treatment of urinary tract infections across age groups. American journal of obstetrics and gynecology, 219(1), 40-51. https://doi.org/10.1016/j.ajog.2017.12.231

Danese, I., Haine, V., Delrue, R. M., Tibor, A., Lestrate, P., Stevaux, O., ... & Letesson, J. J. (2004). The Ton system, an ABC transporter, and a universally conserved GTPase are involved in iron utilization by Brucella melitensis 16M. Infection and immunity, 72(10), 5783-5790.

Finnell, S. M. E., Carroll, A. E., Downs, S. M., & Subcommittee on Urinary Tract Infection. (2011). Diagnosis and management of an initial UTI in febrile infants and young children. Pediatrics, 128(3), e749-e770.

Flores-Mireles, A. L., Walker, J. N., Caparon, M., & Hultgren, S. J. (2015). Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature reviews microbiology, 13(5), 269-284.

Foxman, B. (2014). Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infectious Disease Clinics, 28(1), 1-13.

Ghssein, G., Ezzeddine, Z., Tokajian, S., Khoury, C. A., Kobeissy, H., Ibrahim, J. N., ... & Hassan, H. F. (2025). Brucellosis: Bacteriology, pathogenesis, epidemiology and role of the metallophores in virulence: a review. Frontiers in cellular and infection microbiology, 15, 1621230.

Hooton, T. M. (2012). Uncomplicated urinary tract infection. New England Journal of Medicine, 366(11), 1028-1037.

Köhler, S., Foulongne, V., Ouahrani-Bettache, S., Bourg, G., Teyssier, J., Ramuz, M., & Liautard, J. P. (2002). The analysis of the intramacrophagic virulome of Brucella suis deciphers the environment encountered by the pathogen inside the macrophage host cell. Proceedings of the National Academy of Sciences, 99(24), 15711-15716.

Laine, C. G., Johnson, V. E., Scott, H. M., & Arenas-Gamboa, A. M. (2023). Global estimate of human brucellosis incidence. Emerging infectious diseases, 29(9), 1789.

Lecaroz, C., Blanco-Prieto, M. J., Burrell, M. A., & Gamazo, C. (2006). Intracellular killing of Brucella melitensis in human macrophages with microsphere-encapsulated gentamicin. Journal of antimicrobial chemotherapy, 58(3), 549-556.

Marlid, S. (1998). Incidence rate of first-time symptomatic urinary tract infection in children under 6 years of age. Acta Paediatr, 87, 549-552.

Martirosyan, A., & Gorvel, J. P. (2013). Brucella evasion of adaptive immunity. Future microbiology, 8(2), 147-154.

Nielsen, K. (2002). Diagnosis of brucellosis by serology. Veterinary microbiology, 90(1-4), 447-459. https://doi.org/10.1016/S0378-1135(02)00229-8

Oliveira, S. C., de Oliveira, F. S., Macedo, G. C., de Almeida, L. A., & Carvalho, N. B. (2008). The role of innate immune receptors in the control of Brucella abortus infection: toll-like receptors and beyond. Microbes and Infection, 10(9), 1005-1009. https://doi.org/10.1016/j.micinf.2008.07.005

Paulley, J. T., Anderson, E. S., & Roop, R. M. (2007). Brucella abortus requires the heme transporter BhuA for maintenance of chronic infection in BALB/c mice. Infection and immunity, 75(11), 5248-5254.

Prentiss, K. A., Newby, P. K., & Vinci, R. J. (2011). Adolescent female with urinary symptoms: a diagnostic challenge for the pediatrician. Pediatric emergency care, 27(9), 789-794.

Qureshi, K. A., Parvez, A., Fahmy, N. A., Abdel Hady, B. H., Kumar, S., Ganguly, A., ... & Aspatwar, A. (2023). Brucellosis: epidemiology, pathogenesis, diagnosis and treatment–a comprehensive review. Annals of medicine, 55(2), 2295398.

Roset, M. S., Ibanez, A. E., de Souza Filho, J. A., Spera, J. M., Minatel, L., Oliveira, S. C., ... & Briones, G. (2014). Brucella cyclic β-1, 2-glucan plays a critical role in the induction of splenomegaly in mice. PloS one, 9(7), e101279.

Schroeder, A. R., Chang, P. W., Shen, M. W., Biondi, E. A., & Greenhow, T. L. (2015). Diagnostic accuracy of the urinalysis for urinary tract infection in infants< 3 months of age. Pediatrics, 135(6), 965-971.

Shaikh, N., Morone, N. E., Lopez, J., Chianese, J., Sangvai, S., D’Amico, F., ... & Wald, E. R. (2007). Does this child have a urinary tract infection?. Jama, 298(24), 2895-2904.

Zorc, J. J., Levine, D. A., Platt, S. L., Dayan, P. S., Macias, C. G., Krief, W., ... & Multicenter RSV-SBI Study Group of the Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. (2005). Clinical and demographic factors associated with urinary tract infection in young febrile infants. Pediatrics, 116(3), 644-648.

Published

01-06-2026

How to Cite

Skenderi, E., Dono, A. S., Kuli-Lito, G., & Shkembi, A. (2026). Brucellosis revealed via persistent urinary tract infection. International Journal of Health Sciences, 10(2), 166–173. https://doi.org/10.53730/ijhs.v10n2.15900

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Section

Peer Review Articles