In September 2019, a 46-year-old female was hospitalized at First Affiliated Hospital of Chongqing Medical University due to "recurrent fever for one month, up to 38.9 C accompanied by chills and sweating", but otherwise no complaints. She was treated with meroxicillin sulbactam sodium + ribavirin locally and her temperature back to normal. However, 1 week after treatment, the patient's temperature increased again, with the highest value of 39 C.
After admission to our hospital, besides high body temperature, through laboratorial inspection, she had leucopenia and low neutrophils, slightly elevated hypersensitive C - reactive protein, procalcitonin and other inflammatory parameters (Table 1). Blood culture was positive for Gram-negative bacillus biochemically identified as Brucella melitensis (Fig. 1). Simultaneously, serum agglutination test was positive. The patient was treated with intravenous aminoglycoside etimicin 300 mg (once a day for 14 days) plus minocycline 100 mg (first dosage 200 mg, then once every 12 h) in combination. Her temperature rapidly returned and maintained to normal and she was discharged and continued to take minocycline for 6 months without any recurrent signs during the follow-ups.
Interestingly, the woman did not have any history of exposure to farm animals, drinking raw milk, and blood transfusion. She reported, however, that her husband, a lorry driver, had an intermittent low-grade fever prior to her illness. Her husband had ever been to Lanzhou, Gansu Province (a brucellosis outbreak occurred from vaccine factory's pollution due to failed disinfectants just during that period) and had a short stay in a farm unloading goods. The husband also presented with mild redness of the urethral orifice and complained of testicular pain. Subsequently, his blood culture also grew Brucella melitensis and the serum agglutination test was positive as well. He was treated with the same strategy and recovered.