Brucellosis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Danitza Lukac
Overview
Brucellosis must be differentiated from Typhoid fever, Malaria, Tuberculosis, Lymphoma, Dengue, Leptospirosis, Rheumatic disease, Epstein-barr virus, Toxoplasmosis, Cytomegalovirus, and HIV.
Differentiating Brucellosis from other Diseases
Brucellosis must be differentiated from Typhoid fever, Malaria, Tuberculosis, Lymphoma, Dengue, Leptospirosis, Rheumatic disease, Epstein-barr virus, Toxoplasmosis, Cytomegalovirus, and HIV.[1][2][3][4]
A detailed clinical history which includes recent travel history, recent camping or hunting, consumption of unpasteurized milk or dairy products, and occupational history should be obtained, in order to differentiate Brucellosis from other diseases.
| Differential Diagnosis | Distinguishing Clinical Features |
|---|---|
| Typhoid fever | High persistent fevers (104-105°F), particularly vespertine + constipation + relative bradycardia |
| Malaria | Intermittent fever + chills + sweating + anorexia + nausea + cephalalgia + myalgia + normal CBC or thrombocytopenia and/or hemolytic anemia + hyperbilirubinemia + normal or mild elevated erythrocyte sedimentation rate + hepatosplenomegaly |
| Tuberculosis | Night sweats + weight loss + dry or productive cough. |
| Lymphoma | Painless superficial lymphadenopathy (cervical, supraclavicular, axillary or inguinal) + fever + night sweats + asthenia + weight loss + generalized pruritus |
| Dengue | Fever + cephalalgia + retro orbital pain + myalgias + abdominal pain + arthralgia + cutaneous eruption + hemorrhagic manifestations |
| Leptospirosis | Jaundice with no hepatosplenomegaly + leukocytosis + neutrophilia + elevated erythrocyte sedimentation rate |
| Rheumatic Diseases | Protracted fever + weight loss + polyadenopathy + cough + thoracic pain + hemoptysis + dysphonia + weakness + ocular lesions. |
| Epstein-Barr virus | Low-grade fever nearly all cases+Sore throat(white patches on tongue and back of tongue)+Muscle weakness+fatigue+tender lymphadenopathy, particularly involving the posterior cervical lymph nodes. |
| Toxoplasma | Flu like sypmtoms+swollen lymph nodes+muscle aches and pain that last for a month or more |
| Cytomegalovirus | Enlarged lymph nodes, especially in the neck+fever+fatigue+loss of appetite+malaise+muscle aches+rash+sore throat |
| HIV | Acute retro-viral syndrome presents with flu-like symptoms with fever+ lymphadenopathy+ rash+ fatigue+ myalgia+ arthritic pain+ headache |
Reference
- ↑ Pappas G, Akritidis N, Bosilkovski M, Tsianos E (2005). "Brucellosis". N Engl J Med. 352 (22): 2325–36. doi:10.1056/NEJMra050570. PMID 15930423.
- ↑ Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on January,2017
- ↑ Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management". Curr Clin Top Infect Dis. 15: 115–28. PMID 7546364.
- ↑ 4.0 4.1 Enfermedades infecciosas: Brucelosis -Diagnóstico de Brucelosis,Guia para el Equipo de Salud. Ministerio de Salud-Argentina. http://www.msal.gob.ar/images/stories/bes/graficos/0000000304cnt-guia-medica-brucelosis.pdf. Accessed on February 2, 2016