Brucellosis

What is brucellosis?

Brucellosis is a infection caused by bacteria of the genus Brucella. These bacteria primarily cause disease in animals, such as sheep, pigs, cows, goats, and dogs. Humans can become infected by:

• Eating or drinking contaminated food, particularly unpasteurized milk and cheese.
• Direct contact with an infected animal. the organisms can enter humans through an open wound in the skin, mucous membrane, or conjunctiva.
• Inhaling the organism; This route is a particular problem for laboratory workers or those who work with animals or animal carcasses.

Person-to-person spread is extremely rare.

Brucellosis is now rare in developed countries due to pasteurization of milk and milk products, and diseases control Between Animals About 100-200 cases occur per year in the United States. The global areas classified as high risk are the Mediterranean basin, South and Central America, Eastern Europe, Asia, Africa, the Caribbean and the Middle East.

What are the clinical characteristics of brucellosis?

the incubation The brucellosis period is generally 1 to 8 weeks. The symptoms are variable and not specific.

• Brucellosis can be a acute disease (abrupt onset, short duration) or symptoms may be chronic (durable).
• Most patients have flu-like symptoms, such as fever, discomfort, loss of appetite, muscle aches, sweats and joint pain.
• The infection can spread to the central nervous system causing depression, headache, and irritability or, in advanced cases, meningoencephalitis.
• The infection can also spread to the inner lining of the heart and heart valves; is called endocarditis and occurs in approximately 2% of patients.
• Other complications include epididymis-orchitis (inflammation of the epididymis and / or testicle), granulomatous hepatitis (groups of inflammatory cells in the liver), and arthritis.
• Death from brucellosis is rare, and usually results from meningoencephalitis or endocarditis.

What are the cutaneous manifestations of brucellosis?

Skin complications generally affect less than 5% in patients with systemic brucellosis. A variety of skin lesions have been documented. These include:

• Extended purple-red papulonodular lesions (small bumps)
• Erythema knotty
• Extended maculopapular eruption (flat red-purple or slightly raised spots)
• Extensive purple.

Contact with animals with brucellosis can also cause:

• Contact urticaria - Itching and redness of the upper extremities (and sometimes the face) after a few hours of exposure in veterinarians and animal handlers. This resolves in about 2 weeks and may be due to a allergic reaction.

• Chronic ulceration and multiple abscesses on the skin and subcutaneous tissues in patients at high risk of occupational exposure.

How is the diagnosis of brucellosis made?

Brucellosis can be diagnosed by detecting Brucella organisms in blood or bone marrow samples. Blood tests can also reveal antibodies against bacteria

What is the treatment of brucellosis?

Brucellosis is treated with antibiotics. WHO guidelines recommend the following regimens:

• Combination of doxycycline and rifampicin administered daily for 6 weeks. Convenient regimen but increased risk of relapse.
• Oral doxycycline daily for 6 weeks and intramuscular injection of streptomycin daily for 2 to 3 weeks. It appears to be more effective, especially in relapse prevention.
• Fluoroquinolone (eg, Ciprofloxacin) plus rifampin for 6 weeks.

Relapse of infection occurs in up to 10% of patients, even with appropriate treatment.

How can brucellosis be prevented?

• There is no vaccine against human brucella available, but immunizing animals reduces human exposure to the disease.
• Avoid unpasteurized milk, cheese, or ice.creamespecially when you travel to endemic zones
• People who work with animals and animal carcasses should wear protective clothing.