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cellosis
Brucellosis
– A z o o no sis that m ainly affects d o m estic anim als. It is o ccasio nally transm itted to
m an
by ingestio n o f infected raw m ilk , o r by co ntact (with infected anim als o r with so iled
o bjects thro ugh abrasio n o n the sk in). H um an-to -hum an transm issio n is rare.
– B rucello sis is caused by G ram - negative bacilli o f th e genus Brucella: B. melitensis
(Bs.hoeveisp. and go ats), B. abortus ( cattle), B. suis (p igs) and less co m m o nly , B. canis and
– T h e d isease is fo und wo rld wid e and m ainly in rural areas. T h e true incid ence o f
b rucello sis in tro p ical co untries is p ro b ab ly und erestim ated as it is o ften
und iagno sed .
Clinical features
T he clinical signs and asso ciated sy m p to m s are fluctuating and no n sp ecific. D iagno sis
is d ifficult because o f the bro ad sp ectrum o f clinical m anifestatio ns.
Acute form
– C o m m o n fo rm : grad ual o nset o ver o ne to 2 week s: und ulant fever (up to 3 9 -
4 0 °C )
lasting 1 0 to 1 5 d ay s, night sweats, chills, asthenia, jo int and m uscle p ain. P o ssible
sacro ileitis, arthritis (k nee) and o rch itis.
I n regio ns where m alaria is end em ic, the p o ssibility o f acute brucello sis sho uld be
co nsid ered when a high fever p ersists d esp ite co rrect anti-m alarial treatm ent.
– O ther clinical fo rm s:
• T y p h o id -lik e fo rm : sud d en o nset with signs o f sep ticaem ia; high fever, ty p ho id
state, d elirium , abd o m inal signs.
• S ubacute fo rm : m ild , no n-sp ecific clinical signs that d o no t lead the p atient to seek
m ed ical attentio n. S erum test p o sitive.
Secondary brucellosis
P ro lo nged asthenia, fo cal signs:
– B o ne and jo int invo lvem ent: arth ritis o f th e h ip , sacro ileitis, sp o nd y litis w ith
sciatalgia (p seud o -P o tt's d isease).
– Neuro brucello sis: p seud o - tuberculo sis m ening itis, m ening o encep h alitis; a
co m p licatio n at vertebral site invo lving p erip heral nerves m ay cause m o to r and / o r
senso ry d iso rd ers.
Chronic brucellosis
– G eneral signs; p hy sical and m ental asthenia, sweating and p o ly algia.
– F o cal signs: slo w d evelo p ing bo ne, neuro m eningeal o r visceral fo ci.
Laboratory
– D uring the acute p hase d iagno sis can be co nfirm ed by the d etectio n o f the p atho gen
in a blo o d culture.
– T he R o se B engal test (o r card test) can id entify sp ecific antibo d ies. It is a quick , cheap
and bo th sp ecific and sensitive test fo r the d iagno sis o f acute and lo caliz ed fo rm s o f
brucello sis.
176
Brucellosis
– A z o o no sis that m ainly affects d o m estic anim als. It is o ccasio nally transm itted to
m an
by ingestio n o f infected raw m ilk , o r by co ntact (with infected anim als o r with so iled
o bjects thro ugh abrasio n o n the sk in). H um an-to -hum an transm issio n is rare.
– B rucello sis is caused by G ram - negative bacilli o f th e genus Brucella: B. melitensis
(Bs.hoeveisp. and go ats), B. abortus ( cattle), B. suis (p igs) and less co m m o nly , B. canis and
– T h e d isease is fo und wo rld wid e and m ainly in rural areas. T h e true incid ence o f
b rucello sis in tro p ical co untries is p ro b ab ly und erestim ated as it is o ften
und iagno sed .
Clinical features
T he clinical signs and asso ciated sy m p to m s are fluctuating and no n sp ecific. D iagno sis
is d ifficult because o f the bro ad sp ectrum o f clinical m anifestatio ns.
Acute form
– C o m m o n fo rm : grad ual o nset o ver o ne to 2 week s: und ulant fever (up to 3 9 -
4 0 °C )
lasting 1 0 to 1 5 d ay s, night sweats, chills, asthenia, jo int and m uscle p ain. P o ssible
sacro ileitis, arthritis (k nee) and o rch itis.
I n regio ns where m alaria is end em ic, the p o ssibility o f acute brucello sis sho uld be
co nsid ered when a high fever p ersists d esp ite co rrect anti-m alarial treatm ent.
– O ther clinical fo rm s:
• T y p h o id -lik e fo rm : sud d en o nset with signs o f sep ticaem ia; high fever, ty p ho id
state, d elirium , abd o m inal signs.
• S ubacute fo rm : m ild , no n-sp ecific clinical signs that d o no t lead the p atient to seek
m ed ical attentio n. S erum test p o sitive.
Secondary brucellosis
P ro lo nged asthenia, fo cal signs:
– B o ne and jo int invo lvem ent: arth ritis o f th e h ip , sacro ileitis, sp o nd y litis w ith
sciatalgia (p seud o -P o tt's d isease).
– Neuro brucello sis: p seud o - tuberculo sis m ening itis, m ening o encep h alitis; a
co m p licatio n at vertebral site invo lving p erip heral nerves m ay cause m o to r and / o r
senso ry d iso rd ers.
Chronic brucellosis
– G eneral signs; p hy sical and m ental asthenia, sweating and p o ly algia.
– F o cal signs: slo w d evelo p ing bo ne, neuro m eningeal o r visceral fo ci.
Laboratory
– D uring the acute p hase d iagno sis can be co nfirm ed by the d etectio n o f the p atho gen
in a blo o d culture.
– T he R o se B engal test (o r card test) can id entify sp ecific antibo d ies. It is a quick , cheap
and bo th sp ecific and sensitive test fo r the d iagno sis o f acute and lo caliz ed fo rm s o f
brucello sis.
176
