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__NOTOC__
__NOTOC__
{{Brucellosis}}
{{Brucellosis}}
{{CMG}}; {{AE}} {{DL}}
{{CMG}}; {{AE}} {{DL}} {{VD}}  


==Overview==
==Overview==
The diagnosis of brucellosis is based on the clinical and laboratory criteria.<ref name="e">Brucellosis 2010 Case Definition. CDC. http://wwwn.cdc.gov/nndss/conditions/brucellosis/case-definition/2010/. Accessed on February 2, 2016</ref>
There is no specific diagnostic criteria for Brucellosis, diagnosis is based on history of potential exposure, presentation consistent with the disease, supporting laboratory findings.  
 
==Diagnostic Criteria==
==Diagnostic Criteria==
*'''Clinical Description'''
There is no specific diagnostic criteria for Brucellosis, diagnosis is based on:<ref name=":0">Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 9, 2016</ref><ref name="pmid8699960">{{cite journal| author=Colmenero JD, Reguera JM, Martos F, Sánchez-De-Mora D, Delgado M, Causse M et al.| title=Complications associated with Brucella melitensis infection: a study of 530 cases. | journal=Medicine (Baltimore) | year= 1996 | volume= 75 | issue= 4 | pages= 195-211 | pmid=8699960 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8699960  }} </ref><ref name="pmid17901634">{{cite journal| author=Mantur BG, Amarnath SK, Shinde RS| title=Review of clinical and laboratory features of human brucellosis. | journal=Indian J Med Microbiol | year= 2007 | volume= 25 | issue= 3 | pages= 188-202 | pmid=17901634 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17901634  }} </ref><ref name="pmid15930423">{{cite journal| author=Pappas G, Akritidis N, Bosilkovski M, Tsianos E| title=Brucellosis. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 22 | pages= 2325-36 | pmid=15930423 | doi=10.1056/NEJMra050570 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15930423  }} </ref><ref name="pmid7546364">{{cite journal| author=Young EJ| title=Brucellosis: current epidemiology, diagnosis, and management. | journal=Curr Clin Top Infect Dis | year= 1995 | volume= 15 | issue=  | pages= 115-28 | pmid=7546364 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7546364  }} </ref><ref name="pmid23236528">{{cite journal| author=Dean AS, Crump L, Greter H, Hattendorf J, Schelling E, Zinsstag J| title=Clinical manifestations of human brucellosis: a systematic review and meta-analysis. | journal=PLoS Negl Trop Dis | year= 2012 | volume= 6 | issue= 12 | pages= e1929 | pmid=23236528 | doi=10.1371/journal.pntd.0001929 | pmc=3516581 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23236528  }} </ref><ref name="pmid11971204">{{cite journal| author=Geyik MF, Gür A, Nas K, Cevik R, Saraç J, Dikici B et al.| title=Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. | journal=Swiss Med Wkly | year= 2002 | volume= 132 | issue= 7-8 | pages= 98-105 | pmid=11971204 | doi=2002/07/smw-09900 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11971204  }} </ref><ref name="pmid2330811">{{cite journal| author=Mousa AM, Bahar RH, Araj GF, Koshy TS, Muhtaseb SA, al-Mudallal DS et al.| title=Neurological complications of brucella spondylitis. | journal=Acta Neurol Scand | year= 1990 | volume= 81 | issue= 1 | pages= 16-23 | pmid=2330811 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2330811  }} </ref><ref name="pmid13130417">{{cite journal| author=Pappas G, Bosilkovski M, Akritidis N, Mastora M, Krteva L, Tsianos E| title=Brucellosis and the respiratory system. | journal=Clin Infect Dis | year= 2003 | volume= 37 | issue= 7 | pages= e95-9 | pmid=13130417 | doi=10.1086/378125 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13130417  }} </ref><ref name="pmid24480149">{{cite journal| author=Herrick JA, Lederman RJ, Sullivan B, Powers JH, Palmore TN| title=Brucella arteritis: clinical manifestations, treatment, and prognosis. | journal=Lancet Infect Dis | year= 2014 | volume= 14 | issue= 6 | pages= 520-6 | pmid=24480149 | doi=10.1016/S1473-3099(13)70270-6 | pmc=4498663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24480149  }} </ref>
**An illness characterized by acute or insidious onset of fever and one or more of the following:  
* History of potential exposure
***Night sweats
* Presentation consistent with the disease
***Arthralgia
* Supporting laboratory findings
***Headache
{| class="wikitable"
***Fatigue
! colspan="2" |Diagnosis of brucellosis
***Anorexia
|-
***Myalgia
|History of potential exposure
***Weight loss
|
***Arthritis/spondylitis
* Living or travelling to Brucellosis endemic countries
***Meningitis
***Focal organ involvement (endocarditis, orchitis/epididymitis, hepatomegaly, splenomegaly)
*'''Laboratory Criteria for Diagnosis'''
**''Definitive:''
***Culture and identification of Brucella spp. from clinical specimens
***Evidence of a fourfold or greater rise in Brucella antibody titer between acute- and convalescent-phase serum specimens obtained greater than or equal to 2 weeks apart
**''Presumptive:''
***Brucella total antibody titer of greater than or equal to 160 by standard tube agglutination test (SAT) or Brucella microagglutination test (BMAT) in one or more serum specimens obtained after onset of symptoms
***Detection of Brucella DNA in a clinical specimen by PCR assay


'''Case Classification'''
* Consuming unpasteurized dairy products or raw meat products
*''Probable''
* Unsafe hunting practices
**A clinically compatible illness with at least one of the following:
* Occupational risks such as slaughther house workers, meat-packing employees, and veterinarian
***Epidemiologically linked to a confirmed human or animal brucellosis case
|-
***Presumptive laboratory evidence, but without definitive laboratory evidence, of Brucella infection
|presentation consistent with the disease
*''Confirmed''
|An illness characterized by acute or insidious onset of [[fever]] and one or more of the following:
**A clinically compatible illness with definitive laboratory evidence of Brucella infection<ref name="e">Brucellosis 2010 Case Definition. CDC. http://wwwn.cdc.gov/nndss/conditions/brucellosis/case-definition/2010/. Accessed on February 2, 2016</ref>  
*[[Night sweats]]
*[[Arthralgia]]
*[[Headache]]
*[[Fatigue]]
*[[Anorexia]]
*[[Myalgia]]
*[[Weight loss]]
*[[Arthritis]]/[[spondylitis]]
*[[Meningitis]]
*Focal organ involvement ([[endocarditis]], [[orchitis]]/[[epididymitis]], [[hepatomegaly]], [[splenomegaly]])
|-
|Supporting laboratory findings
|'''Definitive:'''
*Culture and identification of [[Brucella|''Brucella spp'']]. from clinical specimens
*Evidence of a fourfold or greater rise in [[Brucella|''Brucella'']] antibody titer between acute- and convalescent-phase serum specimens obtained greater than or equal to 2 weeks apart
'''Presumptive:'''
*[[Brucella|''Brucella'']] total antibody titer of greater than or equal to 160 by standard tube agglutination test (SAT) or [[Brucella|''Brucella'']] microagglutination test (BMAT) in one or more serum specimens obtained after onset of symptoms
*Detection of [[Brucella|''Brucella'']] DNA in a clinical specimen by [[Polymerase chain reaction|PCR]] assay
Other non-specific findings may include:
* [[Complete blood count]]: Normal or low with relative lymphocytosis. Low platelets may be reported
* [[Hemoglobin]]: Mild anemia is documented
* Normal or elevated [[ESR]]
* Normal or elevated [[C-reactive protein]] levels
* Normal or raised fibrinogen  degraded products 
|-
| colspan="2" |
===                                                                                                              Relapse ===
|-
|Relapse
|
* Relapse is usually suspected in patients with established diagnosis of Brucellosis, when general well being and body weight(loss of body weight) are affected.<ref name=":0" />
* Pcr assay of pheripheral blood is recommended in diagnosis of relapse.<ref name="pmid9350761">{{cite journal| author=Queipo-Ortuño MI, Morata P, Ocón P, Manchado P, Colmenero JD| title=Rapid diagnosis of human brucellosis by peripheral-blood PCR assay. | journal=J Clin Microbiol | year= 1997 | volume= 35 | issue= 11 | pages= 2927-30 | pmid=9350761 | doi= | pmc=230089 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9350761  }}</ref><ref name="pmid12718759">{{cite journal| author=Nimri LF| title=Diagnosis of recent and relapsed cases of human brucellosis by PCR assay. | journal=BMC Infect Dis | year= 2003 | volume= 3 | issue=  | pages= 5 | pmid=12718759 | doi=10.1186/1471-2334-3-5 | pmc=156630 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12718759  }}</ref>
|-
| colspan="2" |
===                                                                                                    Chronic Brucellosis ===
|-
|Chronic Brucellosis
|
* Chronic Brucellosis is diagnosis of exclusion. Chronic Brucellosis, should be considered in patients who present with chronic complains of fatigue, arthralgia, malaise, myalgia, and difficulty in vision for more then one year after established diagnosis of [[brucellosis]].<ref name=":0" />
* Pcr assay of pheripheral blood is recommended in diagnosis of Chronic Brucellosis.<ref name="pmid9350761" /><ref name="pmid12718759" />


|}
==Reference==
==Reference==
{{reflist|2}}
{{reflist|2}}
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[[Category:Occupational diseases]]
[[Category:Occupational diseases]]
[[Category:Zoonoses]]
[[Category:Zoonoses]]
[[Category:Infectious disease]]
 
[[Category:Biological weapons]]
[[Category:Biological weapons]]
[[Category:Disease]]
[[Category:Disease]]

Latest revision as of 17:16, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Danitza Lukac Vishal Devarkonda, M.B.B.S[2]

Overview

There is no specific diagnostic criteria for Brucellosis, diagnosis is based on history of potential exposure, presentation consistent with the disease, supporting laboratory findings.

Diagnostic Criteria

There is no specific diagnostic criteria for Brucellosis, diagnosis is based on:[1][2][3][4][5][6][7][8][9][10]

  • History of potential exposure
  • Presentation consistent with the disease
  • Supporting laboratory findings
Diagnosis of brucellosis
History of potential exposure
  • Living or travelling to Brucellosis endemic countries
  • Consuming unpasteurized dairy products or raw meat products
  • Unsafe hunting practices
  • Occupational risks such as slaughther house workers, meat-packing employees, and veterinarian
presentation consistent with the disease An illness characterized by acute or insidious onset of fever and one or more of the following:
Supporting laboratory findings Definitive:
  • Culture and identification of Brucella spp. from clinical specimens
  • Evidence of a fourfold or greater rise in Brucella antibody titer between acute- and convalescent-phase serum specimens obtained greater than or equal to 2 weeks apart

Presumptive:

  • Brucella total antibody titer of greater than or equal to 160 by standard tube agglutination test (SAT) or Brucella microagglutination test (BMAT) in one or more serum specimens obtained after onset of symptoms
  • Detection of Brucella DNA in a clinical specimen by PCR assay

Other non-specific findings may include:

Relapse

Relapse
  • Relapse is usually suspected in patients with established diagnosis of Brucellosis, when general well being and body weight(loss of body weight) are affected.[1]
  • Pcr assay of pheripheral blood is recommended in diagnosis of relapse.[11][12]

Chronic Brucellosis

Chronic Brucellosis
  • Chronic Brucellosis is diagnosis of exclusion. Chronic Brucellosis, should be considered in patients who present with chronic complains of fatigue, arthralgia, malaise, myalgia, and difficulty in vision for more then one year after established diagnosis of brucellosis.[1]
  • Pcr assay of pheripheral blood is recommended in diagnosis of Chronic Brucellosis.[11][12]

Reference

  1. ↑ 1.0 1.1 1.2 Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 9, 2016
  2. ↑ Colmenero JD, Reguera JM, Martos F, Sánchez-De-Mora D, Delgado M, Causse M; et al. (1996). "Complications associated with Brucella melitensis infection: a study of 530 cases". Medicine (Baltimore). 75 (4): 195–211. PMID 8699960.
  3. ↑ Mantur BG, Amarnath SK, Shinde RS (2007). "Review of clinical and laboratory features of human brucellosis". Indian J Med Microbiol. 25 (3): 188–202. PMID 17901634.
  4. ↑ Pappas G, Akritidis N, Bosilkovski M, Tsianos E (2005). "Brucellosis". N Engl J Med. 352 (22): 2325–36. doi:10.1056/NEJMra050570. PMID 15930423.
  5. ↑ Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management". Curr Clin Top Infect Dis. 15: 115–28. PMID 7546364.
  6. ↑ Dean AS, Crump L, Greter H, Hattendorf J, Schelling E, Zinsstag J (2012). "Clinical manifestations of human brucellosis: a systematic review and meta-analysis". PLoS Negl Trop Dis. 6 (12): e1929. doi:10.1371/journal.pntd.0001929. PMC 3516581. PMID 23236528.
  7. ↑ Geyik MF, Gür A, Nas K, Cevik R, Saraç J, Dikici B; et al. (2002). "Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases". Swiss Med Wkly. 132 (7–8): 98–105. doi:2002/07/smw-09900 Check |doi= value (help). PMID 11971204.
  8. ↑ Mousa AM, Bahar RH, Araj GF, Koshy TS, Muhtaseb SA, al-Mudallal DS; et al. (1990). "Neurological complications of brucella spondylitis". Acta Neurol Scand. 81 (1): 16–23. PMID 2330811.
  9. ↑ Pappas G, Bosilkovski M, Akritidis N, Mastora M, Krteva L, Tsianos E (2003). "Brucellosis and the respiratory system". Clin Infect Dis. 37 (7): e95–9. doi:10.1086/378125. PMID 13130417.
  10. ↑ Herrick JA, Lederman RJ, Sullivan B, Powers JH, Palmore TN (2014). "Brucella arteritis: clinical manifestations, treatment, and prognosis". Lancet Infect Dis. 14 (6): 520–6. doi:10.1016/S1473-3099(13)70270-6. PMC 4498663. PMID 24480149.
  11. ↑ 11.0 11.1 Queipo-Ortuño MI, Morata P, Ocón P, Manchado P, Colmenero JD (1997). "Rapid diagnosis of human brucellosis by peripheral-blood PCR assay" Check |url= value (help). J Clin Microbiol. 35 (11): 2927–30. PMC 230089. PMID 9350761.
  12. ↑ 12.0 12.1 Nimri LF (2003). "Diagnosis of recent and relapsed cases of human brucellosis by PCR assay" Check |url= value (help). BMC Infect Dis. 3 ( ): 5. doi:10.1186/1471-2334-3-5. PMC 156630. PMID 12718759.
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