{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T13:54:05Z","timestamp":1781013245676,"version":"3.54.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T00:00:00Z","timestamp":1621468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T00:00:00Z","timestamp":1621468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National Key Research & Development Plan","award":["U1803236"],"award-info":[{"award-number":["U1803236"]}]},{"name":"National Key Research & Development Plan","award":["37160020"],"award-info":[{"award-number":["37160020"]}]},{"name":"National Key Research & Development Plan","award":["2017AA003"],"award-info":[{"award-number":["2017AA003"]}]},{"name":"National Key Research & Development Plan","award":["32002245"],"award-info":[{"award-number":["32002245"]}]},{"name":"National Key Research & Development Plan","award":["2017YFD0500304"],"award-info":[{"award-number":["2017YFD0500304"]}]},{"name":"National Key Research & Development Plan","award":["2018ZX10101002-007"],"award-info":[{"award-number":["2018ZX10101002-007"]}]},{"DOI":"10.13039\/501100011136","name":"State Key Laboratory of Veterinary Etiological Biology","doi-asserted-by":"publisher","award":["SKLVEB2017KEKT009"],"award-info":[{"award-number":["SKLVEB2017KEKT009"]}],"id":[{"id":"10.13039\/501100011136","id-type":"DOI","asserted-by":"publisher"}]},{"name":"International Scientific and Technological Cooperation in Bingtuan","award":["2016AH001"],"award-info":[{"award-number":["2016AH001"]}]},{"name":"Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences","award":["2020-PT330-003"],"award-info":[{"award-number":["2020-PT330-003"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>This case report describes the clinical process of a shepherd who suffered brucellosis-related endocarditis (BE) and spondylitis (BS) and was infected with <jats:italic>Brucella melitensis biovar<\/jats:italic> 3 (<jats:italic>B. melitensis biovar<\/jats:italic> 3).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 55-year-old male patient was admitted to The First Affiliated Hospital of Shihezi University on October 11, 2018, due to over 3 months of intermittent fever, back pain, and heart trouble. The Rose Bengal Plate test was positive, the standard agglutination test titer for brucellosis was 1\/800, and the blood culture was positive for <jats:italic>B<\/jats:italic>. <jats:italic>melitensis biovar<\/jats:italic> 3. Three instances of transthoracic echocardiography examination at days 1, 25, and 376 after admission to the hospital and magnetic resonance imaging (MRI) and computed tomography (CT) checks at days 5 and 38 revealed that the size of the vegetation on the posterior leaflet of the mitral valve increased from 0.7\u2009\u00d7\u20091.4\u2009cm to 1.2\u2009\u00d7\u20091.5\u2009cm and that the left atrium and ventricle were enlarged. The MRI and CT results showed hyperplasia of the second and third vertebra, a cold abscess formed on both sides of the psoas major muscles, and the vertebra hyperplasia became aggravated at a later time point. The patient\u2019s situation deteriorated, and heart failure was discovered on October 22, 2019. At the moment of submission of this manuscript, the patient remains in bed at home because of severe debility caused by brucellosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This is the first reported case of endocarditis combined with spondylitis caused by <jats:italic>B<\/jats:italic>. <jats:italic>melitensis biovar<\/jats:italic> 3 in a shepherd. Brucellosis infection can cause work-power losses because of misdiagnosis or a lack of proper treatment. Early diagnosis and treatment are essential for a successful outcome.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06142-3","type":"journal-article","created":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T19:09:10Z","timestamp":1621537750000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["A case report of endocarditis and spondylitis caused by Brucella melitensis biovar 3"],"prefix":"10.1186","volume":"21","author":[{"given":"Huan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songsong","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueli","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihai","family":"Yi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingjie","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buyun","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanzhi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuangfu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,20]]},"reference":[{"issue":"2","key":"6142_CR1","doi-asserted-by":"publisher","first-page":"66","DOI":"10.4038\/cmj.v52i2.1028","volume":"52","author":"C Goonaratna","year":"2009","unstructured":"Goonaratna C. Brucellosis in humans and animals. Ceylon Med J. 2009;52(2):66. https:\/\/doi.org\/10.4038\/cmj.v52i2.1028.","journal-title":"Ceylon Med J"},{"issue":"5","key":"6142_CR2","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/S0899-7071(00)00226-6","volume":"24","author":"A Zormpala","year":"2000","unstructured":"Zormpala A, Skopelitis E, Thanos L, Artinopoulos C, Sipsas NV. An unusual case of brucellar spondylitis involving both the cervical and lumbar spine. Clin Imaging. 2000;24(5):273\u20135. https:\/\/doi.org\/10.1016\/S0899-7071(00)00226-6.","journal-title":"Clin Imaging"},{"issue":"5","key":"6142_CR3","doi-asserted-by":"publisher","first-page":"e289","DOI":"10.1016\/j.ijid.2012.12.030","volume":"17","author":"Z Zhong","year":"2013","unstructured":"Zhong Z, Yu S, Wang X, Dong S, Xu J, Wang Y, et al. Human brucellosis in the people\u2019s republic of China during 2005\u20132010. Int J Infect Dis. 2013;17(5):e289\u2013e92. https:\/\/doi.org\/10.1016\/j.ijid.2012.12.030.","journal-title":"Int J Infect Dis"},{"key":"6142_CR4","first-page":"17","volume-title":"Brucellosis control manual","author":"DLGS Xiao","year":"2008","unstructured":"Xiao DLGS, Wang DL, Wang JQ, Li TF, Cui BY, et al. Brucellosis control manual. Beijing: Beijing People\u2019s Medical Publishing House; 2008. p. 17\u201329."},{"key":"6142_CR5","unstructured":"Zhang H, Shengnan S, Benben W, Jiang Y, Wenxing W, Fei G, et al. Brucella melitensis isolated from aborted cow and sheep fetuses in northwest of China. Kafkas \u00dcniversitesi Veteriner Fak\u00fcltesi Dergisi. 2018;24(2)307\u201310."},{"issue":"12","key":"6142_CR6","doi-asserted-by":"publisher","first-page":"3041","DOI":"10.1093\/molbev\/msy194","volume":"35","author":"G Yu","year":"2018","unstructured":"Yu G, Lam TT, Zhu H, Guan Y. Two methods for mapping and visualizing associated data on phylogeny using Ggtree. Mol Biol Evol. 2018;35(12):3041\u20133. https:\/\/doi.org\/10.1093\/molbev\/msy194.","journal-title":"Mol Biol Evol"},{"key":"6142_CR7","unstructured":"Zhang H, Benben W, Jihai Y, Zhen W, Zhang J, Yuanzhi W, et al. Brucella suis S2 isolated from aborted sheep fetuses in northwestern China. Kafkas Universitesi Veteriner Fakultesi Dergisi. 2019;25(6):869\u201372."},{"issue":"4","key":"6142_CR8","doi-asserted-by":"publisher","first-page":"804","DOI":"10.3201\/eid2604.190833","volume":"26","author":"X Liu","year":"2020","unstructured":"Liu X, Yang M, Song S, Liu G, Zhao S, Liu G, et al. Brucella melitensis in Asian badgers, northwestern China. Emerg Infect Dis. 2020;26(4):804\u20136. https:\/\/doi.org\/10.3201\/eid2604.190833.","journal-title":"Emerg Infect Dis"},{"key":"6142_CR9","doi-asserted-by":"publisher","unstructured":"Voelker CDCPSER. Brucella in raw Milk prompts health warning in Texas. Jama. 2017. https:\/\/doi.org\/10.1001\/jama.2017.15338.","DOI":"10.1001\/jama.2017.15338"},{"issue":"1","key":"6142_CR10","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/s40249-018-0411-x","volume":"7","author":"HX Yang","year":"2018","unstructured":"Yang HX, Feng J-J, Zhang Q-X, Hao R-E, Yao S-X, Zhao R, et al. A case report of spontaneous abortion caused by Brucella melitensis biovar 3. Infect Dis Poverty. 2018;7(1):31. https:\/\/doi.org\/10.1186\/s40249-018-0411-x.","journal-title":"Infect Dis Poverty"},{"issue":"5","key":"6142_CR11","doi-asserted-by":"publisher","first-page":"e0005577","DOI":"10.1371\/journal.pntd.0005577","volume":"11","author":"B Jia","year":"2017","unstructured":"Jia B, Zhang F, Ying L, Zhang W, Li J, Zhang Y, et al. The clinical features of 590 patients with brucellosis in Xinjiang, China with the emphasis on the treatment of complications. PLoS Negl Trop Dis. 2017;11(5):e0005577.","journal-title":"PLoS Negl Trop Dis"},{"issue":"12","key":"6142_CR12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001929","volume":"6","author":"AS Dean","year":"2012","unstructured":"Dean AS, Crump L, Greter H, Hattendorf J, Schelling E, Zinsstag J, et al. Clinical manifestations of human brucellosis: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2012;6(12):e1929. https:\/\/doi.org\/10.1371\/journal.pntd.0001929.","journal-title":"PLoS Negl Trop Dis"},{"issue":"5","key":"6142_CR13","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1016\/j.jinf.2017.01.011","volume":"74","author":"B Jia","year":"2017","unstructured":"Jia B, Zhang F, Pang P, Zhang T, Zheng R, Zhang W, et al. Brucella endocarditis: clinical features and treatment outcomes of 10 cases from Xinjiang, China. J Infect. 2017;74(5):512\u20134. https:\/\/doi.org\/10.1016\/j.jinf.2017.01.011.","journal-title":"J Infect"},{"key":"6142_CR14","doi-asserted-by":"crossref","unstructured":"Dourakis S, Sambatakou H, Tsiachris D, Kittou N, Alexopoulou A, Archimandritis A. A 70-year-old stock-breeder with tricuspid valve and defibrillator lead brucella endocarditis. Int J Cardiol. 2008;126(3):e47\u2013e49.","DOI":"10.1016\/j.ijcard.2007.01.018"},{"issue":"1","key":"6142_CR15","doi-asserted-by":"publisher","DOI":"10.15406\/jccr.2015.05.00149","volume":"5","author":"M Mahjoub","year":"2016","unstructured":"Mahjoub M, Hassine M, Boussaada M, Ben Messaoud M, Cheniti G. Brucellosis as an unusual cause of mitral infective endocarditis. J Cardiol Curr Res. 2016;5(1):00149.","journal-title":"J Cardiol Curr Res"},{"issue":"6","key":"6142_CR16","doi-asserted-by":"publisher","first-page":"2141","DOI":"10.1016\/j.athoracsur.2012.07.006","volume":"94","author":"M Keshtkarjahromi","year":"2012","unstructured":"Keshtkarjahromi M, Razavi SM, Gholamin S, Keshtkarjahromi M, Hossain M, Sajadi M. Medical vs. medical and surgical treatment for brucella endocarditis: a review of the literature. Ann Thorac Surg. 2012;94(6):2141.","journal-title":"Ann Thorac Surg"},{"issue":"2","key":"6142_CR17","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.ijantimicag.2012.04.009","volume":"40","author":"ST Koruk","year":"2012","unstructured":"Koruk ST, Erdem H, Koruk I, Erbay AE, Tezer-Tekce Y, Erbay AR, et al. Management of Brucella endocarditis: results of the Gulhane study. Int J Antimicrob Agents. 2012;40(2):145\u201350. https:\/\/doi.org\/10.1016\/j.ijantimicag.2012.04.009.","journal-title":"Int J Antimicrob Agents"},{"key":"6142_CR18","doi-asserted-by":"publisher","unstructured":"Ulu-Kilic A, Karakas A, Erdem H, Turker T, Alabay S. Update on treatment options for spinal brucellosis. Clin Microbiol Infect. 2014;20(2). https:\/\/doi.org\/10.1111\/1469-0691.12351.\u00a0","DOI":"10.1111\/1469-0691.12351"},{"issue":"12","key":"6142_CR19","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1007\/s11547-014-0416-x","volume":"119","author":"X Yang","year":"2014","unstructured":"Yang X, Zhang Q, Guo X. Value of magnetic resonance imaging in brucellar spondylodiscitis. La Radiologia Medica. 2014;119(12):928\u201333. https:\/\/doi.org\/10.1007\/s11547-014-0416-x.","journal-title":"La Radiologia Medica"},{"issue":"4","key":"6142_CR20","doi-asserted-by":"publisher","first-page":"873","DOI":"10.2214\/AJR.05.1088","volume":"187","author":"A Pourbagher","year":"2006","unstructured":"Pourbagher A, Pourbagher MA, Savas L, Turunc T, Demiroglu YZ, Erol I, et al. Epidemiologic, clinical, and imaging findings in brucellosis patients with osteoarticular involvement. AJR Am J Roentgenol. 2006;187(4):873\u201380. https:\/\/doi.org\/10.2214\/AJR.05.1088.","journal-title":"AJR Am J Roentgenol"},{"issue":"12","key":"6142_CR21","doi-asserted-by":"publisher","first-page":"2509","DOI":"10.1016\/j.spinee.2015.09.024","volume":"15","author":"H Erdem","year":"2015","unstructured":"Erdem H, Elaldi N, Batirel A, Aliyu S, Sengoz G, et al. Comparison of brucellar and tuberculous spondylodiscitis patients: results of the multicenter \"Backbone-1 study\". Spine J. 2015;15(12):2509\u201317.","journal-title":"Spine J"},{"issue":"3","key":"6142_CR22","doi-asserted-by":"publisher","first-page":"e47","DOI":"10.1016\/j.ijcard.2007.01.018","volume":"126","author":"S Dourakis","year":"2008","unstructured":"Dourakis S, Sambatakou H, Tsiachris D, Kittou N, Alexopoulou A, Archimandritis A. A 70-year-old stock-breeder with tricuspid valve and defibrillator lead brucella endocarditis. Int J Cardiol. 2008;126(3):e47\u2013e9. https:\/\/doi.org\/10.1016\/j.ijcard.2007.01.018.","journal-title":"Int J Cardiol"},{"key":"6142_CR23","doi-asserted-by":"publisher","first-page":"387","DOI":"10.2147\/IDR.S152771","volume":"11","author":"AA Wasl Al-Adsani","year":"2018","unstructured":"Wasl Al-Adsani AA, Al-Mousa M. A case of Brucella melitensis endocarditis in a patient with cardiovascular implantable electronic device. Infect Drug Resist. 2018;11:387\u201390. https:\/\/doi.org\/10.2147\/IDR.S152771.","journal-title":"Infect Drug Resist"},{"key":"6142_CR24","volume-title":"Brucella endocarditis: heart views","author":"HA Shawky","year":"2006","unstructured":"Shawky HA. Brucella endocarditis: heart views; 2006."},{"issue":"1","key":"6142_CR25","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/BF01704893","volume":"20","author":"JD Colmenero","year":"1992","unstructured":"Colmenero JD, Cisneros JM, Orjuela DL, Pach\u00f3n J, Juarez C. Clinical course and prognosis of Brucella spondylitis. Infection. 1992;20(1):38\u201342. https:\/\/doi.org\/10.1007\/BF01704893.","journal-title":"Infection."},{"key":"6142_CR26","doi-asserted-by":"publisher","first-page":"1565","DOI":"10.2147\/IDR.S202440","volume":"12","author":"C Liang","year":"2019","unstructured":"Liang C, Wei W, Liang X, De E, Zheng B. Spinal brucellosis in Hulunbuir, China, 2011-2016. Infect Drug Resist. 2019;12:1565\u201371. https:\/\/doi.org\/10.2147\/IDR.S202440.","journal-title":"Infect Drug Resist"},{"issue":"11","key":"6142_CR27","doi-asserted-by":"publisher","first-page":"2909","DOI":"10.1007\/s00296-012-2555-5","volume":"33","author":"A Ulu-Kilic","year":"2013","unstructured":"Ulu-Kilic A, Sayar MS, T\u00fct\u00fcnc\u00fc E, et al. Complicated brucellar spondylodiscitis: experience from an endemic area. Rheumatol Int. 2013;33(11):2909\u201312. https:\/\/doi.org\/10.1007\/s00296-012-2555-5.","journal-title":"Rheumatol Int"},{"issue":"3","key":"6142_CR28","first-page":"251","volume":"37","author":"X Yang","year":"2017","unstructured":"Yang X, Yan H, Wang N, Li Y, Bie P, Zang J, et al. Whole-genome sequencing of Brucella melitensis from Xinjiang provides insights into its genetic features. Pak Vet J. 2017;37(3):251\u20136.","journal-title":"Pak Vet J"},{"issue":"6","key":"6142_CR29","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1016\/j.ijid.2008.03.014","volume":"12","author":"E Alp","year":"2008","unstructured":"Alp E, Doganay M. Current therapeutic strategy in spinal brucellosis. Int J Infect Dis. 2008;12(6):573\u20137. https:\/\/doi.org\/10.1016\/j.ijid.2008.03.014.","journal-title":"Int J Infect Dis"},{"issue":"13","key":"6142_CR30","doi-asserted-by":"publisher","first-page":"1831","DOI":"10.4103\/0366-6999.159362","volume":"128","author":"L-D Jiao","year":"2015","unstructured":"Jiao L-D, Chu C-B, Kumar CJ, Cui J, Wang X-L, Wu L-Y, et al. Clinical and laboratory findings of nonacute Neurobrucellosis. Chin Med J. 2015;128(13):1831\u20133. https:\/\/doi.org\/10.4103\/0366-6999.159362.","journal-title":"Chin Med J"},{"key":"6142_CR31","doi-asserted-by":"publisher","unstructured":"Tarfarosh SFA, Manzoor M. Neurological manifestations of brucellosis in an Indian population. Cureus. 2016,8(7).https:\/\/doi.org\/10.7759\/cureus.684.","DOI":"10.7759\/cureus.684"},{"issue":"12","key":"6142_CR32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040317","volume":"4","author":"J Ariza","year":"2007","unstructured":"Ariza J, Bosilkovski M, Cascio A, Colmenero J, Corbel M, Falagas M, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med. 2007;4(12):e317. https:\/\/doi.org\/10.1371\/journal.pmed.0040317.","journal-title":"PLoS Med"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06142-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06142-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06142-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T19:10:26Z","timestamp":1621537826000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06142-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,20]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6142"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06142-3","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,20]]},"assertion":[{"value":"6 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Ethics Committee of the First Affiliated Hospital of Shihezi University approved the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient agreed the publication of the data in this study and provided a written informed agreement.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"460"}}