A patient with a H/O laparoscopic hernioplasty with a mesh was investigated for PUO. His culture is negative for Brucella on three separate occasions but SAT positive for Brucella abortus and negative for melitensis.
Subsequently, USG showed pus collection in the surgical site which showed AFB. Culture for mycobacteria has been put up to differentiate between MTB and MOTT.
Can infection with mycobacteria give a false positive SAT for Brucella abortus.
there are many gram negative bacteria cross reacted with brucella such as yersinia, e.coli , salmonella enteritica, ochrobactrum but I had never read about cross reaction with mycobacteria. may be the patient has mixed infection. What about PCR because some time amount of bacteria in samples have little bacteria that cannot grow in media but give positive with PCR
Thanks Gamal. Currently we are not doing PCR for diagnosis of Brucellosis in our Institute.
As Dr. Gamal answered, Brucella is unlikely the cause. Brucella is not usually pyogenic in nature. It is not an AFB, but a weak acid fast coccobacillus. In other words, it resists decolorization by 0.5% acetic acid for 30 seconds in the modified Ziehl Neelsen method using carbol fuchsin of mycobacteria diluted 1/10. SAT is inconclusive in nature especially at low titers. CFT is a good confirmatory test for brucellosis. I think you have to focus on MTB and MOTT.
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