Congenital brucellosis in a preterm infant: A case report from France and literature review

TL;DR

A rare case of congenital brucellosis in a preterm infant in France is reported, emphasizing the importance of considering this infection in newborns with sepsis and a history of travel or raw dairy consumption.

Contribution

This is the first documented case of congenital brucellosis in France since 1990, highlighting diagnostic and clinical considerations.

Findings

The neonate remained asymptomatic until day 13, with a positive blood culture at that time.

Most recent cases of neonatal brucellosis involve B. melitensis and present with symptoms like respiratory distress or sepsis.

Rifampicin and TMP-SMX treatment for six weeks showed favorable outcomes in most cases.

Abstract

Congenital brucellosis is a rare but serious transplacental infection.

Brucellosis is a bacterial zoonosis, that has become extremely rare in France unlike many countries in the Mediterranean basin, where it remains endemic and is a cause of travel-related morbidity. We have reported the first case of neonatal brucellosis in France since 1990, involving a preterm infant born at 26 weeks with Brucella melitensis chorioamnionitis, due to mother-to-fetal transmission. A PubMed review (2000–2024) identified 13 additional neonatal cases.

The mother had consumed unpasteurized cheese during early pregnancy in Spain. Maternal Blood cultures at delivery were positive for B. melitensis. The neonate remained asymptomatic until day 13, when blood culture -negative at birth- became positive. Despite delayed treatment, clinical respone was favorable. Since 2000, most cases have involved B. melitensis, presenting with respiratory distress, sepsis, or hepatomegaly. Infants were mainly treated with Rifampicin and TMP-SMX for six weeks, with overall favorable outcomes despite occasional severe or chronic cases.

This rare case highlights the need to consider brucellosis in maternal fever or unexplained neonatal sepsis, with travel and dietary history guiding early diagnosis.

•First documented case of congenital brucellosis in France in the 21st century.•A typical presentation in a preterm infant with delayed onset of clinical symptoms.•Consider Brucella in maternal fever or neonatal sepsis with travel or raw dairy exposure.•PCR allows rapid diagnosis, while blood culture remains the gold standard.•Empirical neonatal therapy including rifampin is advised in maternal infection.

First documented case of congenital brucellosis in France in the 21st century.

A typical presentation in a preterm infant with delayed onset of clinical symptoms.

Consider Brucella in maternal fever or neonatal sepsis with travel or raw dairy exposure.

PCR allows rapid diagnosis, while blood culture remains the gold standard.

Empirical neonatal therapy including rifampin is advised in maternal infection.