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7. Bacterial diseases
– O th er sero lo gical tests ( W righ t's test, E L I S A , ind irect im m unfluo rescence and
C o o m bs‟test) canno t usually be d o ne.
Treatment
T reatm ent is based o n a co m binatio n o f 2 antibio tics. S ince strep to m y cin and
rifam p icin
are also used in the treatm ent o f tuberculo sis, it is essential to rule o ut the p o ssibility o f
active T B befo re starting treatm ent (p atient histo ry , clinical exam inatio n and chest X -ray
if p o ssible). R ifam p icin m ust o nly be used when ind icated belo w.
Acute form
– CdoxhyilcdyrcelinneoPveOr 8 y ears and ad ults (excep t in p regnant o r breast-feed ing wo m en):
C hild ren: 1 0 0 to 2 0 0 m g o nce d aily o r in 2 d ivid ed d o ses fo r 6 week s
A d ults: 2 0 0 m g o nce d aily o r in 2 d ivid ed d o ses fo r 6 week s
+ streptomycin I M
C hild ren: 1 5 m g/ k g o nce d aily fo r 2 week s
A d ults: 1 g o nce d aily fo r 2 week s
– CcothriimldorxeanzoulnedPeOr 8 :y4e0arms g S M X + 8 m g T M P / k g/ d ay in 2 d ivid ed d o ses fo r 6
+ gentamicin IM : 7 .5 m g/ k g o nce d aily o r in 2 d ivid ed d o ses fo r 2 week s
o r rifampicin P O : 1 5 m g/ k g o nce d aily fo r 6 week s
– PcotrreimgnoaxanztoolerPbrOeas:t1-fe6e0d0ingmwog mS MenX + 3 2 0 m g T M P / d ay in 2 d ivid ed d o ses fo r
N+otreif:ampicin P O : 6 0 0 m g o nce d aily fo r 6 week s
In p regnant w7o m en, th e co m binatio n o f co trim o xaz o le + rifam p icin can
be
ad m inistered regard less o f the stage o f p regnancy if treatm ent is ind isp ensable.
pAhydtommeninaidsitoranetio(vniaol cfovintatamininingK1 0ismrecgo/ mm ml, 1emnd el)d: to p revent neo natal and m aternal
haem o rrhage.
T o the m o ther: 1 0 m g/ d ay P O fo r the 1 5 d ay s p reced ing the exp ected d ate o f
d elivery
T o the newbo rn: 2 m g P O as a single d o se at birth and again after 4 to 7 d ay s
Focal brucellosis
– S am e treatm ent regim en as fo r th e acute fo rm , but fo r a p erio d o f 6 w eek s to
3 m o nths d ep end ing o n severity . S urgical d raining o f an abscess o f the liver o r sp leen
m ay be ind icated .
– Neuro brucello sis o r end o card itis: co m binatio n o f rifampicin + doxycycline + gentamicin.
A ntibio tic treatm ent is no t effective in the co ntext o f chro nic, no n-fo cal brucello sis.
Prevention
– W ashing o f hand s and clo thing if in co ntact with anim als.
– B o il m ilk and avo id eating raw cheese and und erco o k ed m eat.
– O th er sero lo gical tests ( W righ t's test, E L I S A , ind irect im m unfluo rescence and
C o o m bs‟test) canno t usually be d o ne.
Treatment
T reatm ent is based o n a co m binatio n o f 2 antibio tics. S ince strep to m y cin and
rifam p icin
are also used in the treatm ent o f tuberculo sis, it is essential to rule o ut the p o ssibility o f
active T B befo re starting treatm ent (p atient histo ry , clinical exam inatio n and chest X -ray
if p o ssible). R ifam p icin m ust o nly be used when ind icated belo w.
Acute form
– CdoxhyilcdyrcelinneoPveOr 8 y ears and ad ults (excep t in p regnant o r breast-feed ing wo m en):
C hild ren: 1 0 0 to 2 0 0 m g o nce d aily o r in 2 d ivid ed d o ses fo r 6 week s
A d ults: 2 0 0 m g o nce d aily o r in 2 d ivid ed d o ses fo r 6 week s
+ streptomycin I M
C hild ren: 1 5 m g/ k g o nce d aily fo r 2 week s
A d ults: 1 g o nce d aily fo r 2 week s
– CcothriimldorxeanzoulnedPeOr 8 :y4e0arms g S M X + 8 m g T M P / k g/ d ay in 2 d ivid ed d o ses fo r 6
+ gentamicin IM : 7 .5 m g/ k g o nce d aily o r in 2 d ivid ed d o ses fo r 2 week s
o r rifampicin P O : 1 5 m g/ k g o nce d aily fo r 6 week s
– PcotrreimgnoaxanztoolerPbrOeas:t1-fe6e0d0ingmwog mS MenX + 3 2 0 m g T M P / d ay in 2 d ivid ed d o ses fo r
N+otreif:ampicin P O : 6 0 0 m g o nce d aily fo r 6 week s
In p regnant w7o m en, th e co m binatio n o f co trim o xaz o le + rifam p icin can
be
ad m inistered regard less o f the stage o f p regnancy if treatm ent is ind isp ensable.
pAhydtommeninaidsitoranetio(vniaol cfovintatamininingK1 0ismrecgo/ mm ml, 1emnd el)d: to p revent neo natal and m aternal
haem o rrhage.
T o the m o ther: 1 0 m g/ d ay P O fo r the 1 5 d ay s p reced ing the exp ected d ate o f
d elivery
T o the newbo rn: 2 m g P O as a single d o se at birth and again after 4 to 7 d ay s
Focal brucellosis
– S am e treatm ent regim en as fo r th e acute fo rm , but fo r a p erio d o f 6 w eek s to
3 m o nths d ep end ing o n severity . S urgical d raining o f an abscess o f the liver o r sp leen
m ay be ind icated .
– Neuro brucello sis o r end o card itis: co m binatio n o f rifampicin + doxycycline + gentamicin.
A ntibio tic treatm ent is no t effective in the co ntext o f chro nic, no n-fo cal brucello sis.
Prevention
– W ashing o f hand s and clo thing if in co ntact with anim als.
– B o il m ilk and avo id eating raw cheese and und erco o k ed m eat.
