Congenital brucellosis in an infant.

Brucellosis has been reported mainly among pregnant women, and it may lead to spontaneous abortion, intrauterine fetal death, or delivery of an infected neonate. Transmission through breast milk has also been described, but congenital cases are not commonly reported. We present the clinical findings, laboratory studies, treatment, and final outcome of a late prenatal transmission from a mother to her term infant of Brucella melitensis biovar 1. Because the maternal disease was undetected due to lack of clinical suspicion, diagnosis was made possible only by the results of infant blood cultures. Differential diagnosis of fever of unknown origin (FUO) misdiagnosed could result, as in our case, in the administration of inappropriate antimicrobial therapy. Primary health care physicians should be alerted to the clinical and laboratory findings of this infection, and pregnant women should routinely be tested serologically in areas where brucellosis is still a problem.