Objectives:

Brucellosis is a zoonotic disease whose prevalence in Northern Greece is high and constitutes a significant problem for the local health authorities. The aim of this study is to report a rare case of transmission of Brucella melitensis.

Patients:

A female infant showed signs of respiratory distress during delivery. The obstetrician in charge tried to clear the respiratory tract of saliva and amniotic fluid. In his attempt he swallowed some secretions. A blood culture from the infant was incubated in the Bactec 9120. After 3 days B. melitansis was isolated. The case was proved to be a rare case of congenital brucellosis. The family of the infant was checked and the mother was found to be positive at 1/80 titre by Brucella agglutination test though her blood culture was negative. Neither her husband nor her other two children were positive on the Wright agglutination test. Both parents were involved in animal husbandry. Two months after the delivery of the infected infant the obstetrician reported pains in the back of his neck and low fever. A blood test revealed leucopenia and neutropenia (white cell count 2800/mm³). The Wright agglutination test was positive at titre 1/80. A blood culture was taken and B. melitensis was isolated. Transaminases were normal. The obstetrician reported that he had not consumed unpasteurised milk or dairy products. He was treated with vibramycin and rifadin for 40 days. Two months later the Wright agglutination test was found negative and the white cell count was normal.

Conclusions:

B. melitansis is usually transmitted through consumption of unpasteurised diary products. In these cases we had transplacental transmission and transmission through infectious secretions via the gastro-intestinal tract. Therefore it is essential that detailed medical case histories should be taken from pregnant women in order to avoid congenital infections and that medical personnel should be aware of the possibility of such transmission.