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 Vishal Devarkonda, M.B.B.S[2]

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 raw meat products, and occupational history should be obtained, in order to differentiate Brucellosis from other diseases.

Differentiating Brucellosis from other Diseases[4]
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

  1. Pappas G, Akritidis N, Bosilkovski M, Tsianos E (2005). "Brucellosis". N Engl J Med. 352 (22): 2325–36. doi:10.1056/NEJMra050570. PMID 15930423.
  2. 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
  3. Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management". Curr Clin Top Infect Dis. 15: 115–28. PMID 7546364.
  4. 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