Brucellosis Due to Self-inoculation

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Abstract
A veterinarian with previous exposure to brucellosis accidentally Injected himself with Brucella abortus, strain 19. This is an attenuated organism, used for inoculating cattle. Within 8 hr. he developed fever, chills, headache, and general muscle aching. Treatment with oxytetra-cycline was started the next day, but all his symptoms persisted and he had to be hospitalized. His thumb was tense, red, and swollen at the injection site. Steroids were started, and symptoms disappeared and temperature remitted to normal within 12 hr. Brucella abortus, strain 19, could still be cultured from the inoculation site 2 days later. Brucella endotoxin can reproduce the clinical pattern of acute brucellosis in hypersensitive individuals. In this patient, the oxytetracycline killed brucella cells localized at the inoculation site, and endotoxin was released into his circulation to produce a reaction of sensitivity. If he had not been previously infected by Brucella, the sensitivity reaction would not have occurred, and an antibiotic alone would have been sufficient treatment. His partial immunity, paradoxically, served to accentuate and prolong his symptoms. Steroids should be combined with antibiotics for the treatment of such accidents. The problem of minimizing risk for a veterinarian who has experienced one such reaction and must continue to inoculate cattle seems unanswered at this time.

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