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


==Overview==
==Overview==
[[Symptoms]] of brucellosis include [[undulant fever]], [[night sweats]] (with characteristic smell, likened to wet hay), and [[joint pain]].<ref name="b">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 4, 2016</ref>
Brucellosis can present with diverse clinical presentation which include systemic [[flu]]-like symptoms and symptoms due to focal involvement of organs by the [[bacteria]].


==Symptoms==
==Symptoms==
*[[Acute (medical)|Acute]] brucellosis may begin with mild [[flu]]-like [[symptoms]], or [[symptoms]] such as:
Patients with [[brucellosis]], can present with diverse clinical presentation which include systemic flu-like symptoms and symptoms due to focal involvement of organs by the bacteria:<ref>Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 9th, 2017
** [[Undulant fever]]
</ref><ref>Colmenero JD, Reguera JM, Martos F, Sánchez-De-Mora D, Delgado M, Causse M; et al. (1996). [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8699960 "Complications associated with Brucella melitensis infection: a study of 530 cases."]. ''Medicine (Baltimore)''. '''75''' (4): 195–211. PMID [http://www.ncbi.nlm.nih.gov/pubmed/8699960 8699960]</ref><ref>Mantur BG, Amarnath SK, Shinde RS (2007). [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17901634 "Review of clinical and laboratory features of human brucellosis."]. ''Indian J Med Microbiol''. '''25''' (3): 188–202. PMID [http://www.ncbi.nlm.nih.gov/pubmed/17901634 17901634]</ref><ref>Pappas G, Akritidis N, Bosilkovski M, Tsianos E (2005). [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15930423 "Brucellosis."]. ''N Engl J Med''. '''352''' (22): 2325–36. PMID [http://www.ncbi.nlm.nih.gov/pubmed/15930423 15930423]. </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>Young EJ (1995). [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7546364 "Brucellosis: current epidemiology, diagnosis, and management."]. ''Curr Clin Top Infect Dis''. '''15''': 115–28. PMID [http://www.ncbi.nlm.nih.gov/pubmed/7546364 7546364]</ref><ref>Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.</ref><ref name="pmid21623056">{{cite journal| author=Zamani A, Kooraki S, Mohazab RA, Zamani N, Matloob R, Hayatbakhsh MR et al.| title=Epidemiological and clinical features of Brucella arthritis in 24 children. | journal=Ann Saudi Med | year= 2011 | volume= 31 | issue= 3 | pages= 270-3 | pmid=21623056 | doi=10.4103/0256-4947.81543 | pmc=3119967 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21623056 }}</ref><ref>Mousa AM, Bahar RH, Araj GF, Koshy TS, Muhtaseb SA, al-Mudallal DS; et al. (1990). [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2330811 "Neurological complications of brucella spondylitis."]. ''Acta Neurol Scand''. '''81''' (1): 16–23. PMID [http://www.ncbi.nlm.nih.gov/pubmed/2330811 2330811]</ref><ref>Pappas G, Bosilkovski M, Akritidis N, Mastora M, Krteva L, Tsianos E (2003). [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13130417 "Brucellosis and the respiratory system."]. ''Clin Infect Dis''. '''37''' (7): e95–9. PMID [http://www.ncbi.nlm.nih.gov/pubmed/13130417 13130417]. [[Digital object identifier|doi]]:[http://dx.doi.org/10.1086%2F378125 10.1086/378125]</ref><ref>Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.</ref><ref name="pmid18162038">{{cite journal| author=Ariza J, Bosilkovski M, Cascio A, Colmenero JD, Corbel MJ, Falagas ME et al.| title=Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. | journal=PLoS Med | year= 2007 | volume= 4 | issue= 12 | pages= e317 | pmid=18162038 | doi=10.1371/journal.pmed.0040317 | pmc=2222927 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18162038  }}</ref>
***High fever spikes usually occur every afternoon
{| class="wikitable"
** [[Night sweats]]
! colspan="2" |Brucellosis history and symptoms
***Often with characteristic smell, likened to wet hay
|-
** [[Abdominal pain]]
|Acute brucellosis
** [[Back pain]]
|Systemic symptoms
** [[Chills]]
*[[Undulant fever]]
** [[Fatigue]]
**High fever spikes usually occur every afternoon
** [[Headache]]
*[[Night sweats]]
** [[Joint pain]]
**Often with characteristic smell, likened to wet hay
** [[Loss of appetite]]
*[[Chills]]
** [[Weakness]]
*[[Fatigue]]
** [[Weight loss]]
*[[Loss of appetite]]
** [[Clinical depression|Depression]]
*[[Weakness]]
* Some [[Signs and Symptoms|signs and symptoms]] may persist for longer periods of time. Others may never go away or reoccur.<ref name="b">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on January 29, 2016</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=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15930423 }} </ref><ref name="a">Brucellosis. CDC. http://www.cdc.gov/brucellosis/transmission/index.html. Accessed on February 1, 2016</ref>  
*[[Weight loss]]


* [[Clinical depression|Depression]]
Focal organ wise symptoms:
* Muscuoskeletal: [[Joint pain]](Commonly in low back and larger joints of [[lower limbs]])
* [[Genitourinary system|Genitourinary]]: Pain in the [[Genital|genital region]] and increase in frequency of [[urination]]/[[Burning during urination|burning senation]] while passing [[urine]](2 to 20 percent of cases)
* [[Pulmonary]]: [[Cough]], [[chest pain]], [[difficulty in breathing]](pulmonary involvement present upto 7 percent of patients)
* [[Gastrointestinal]]: [[Abdominal pain]] and symptoms of [[hepatitis]] can be present in 3-6 percent of presenting patients
* [[Neurological]]: [[Headache]], [[confusion]] or [[Altered mental state|altered sensorium]] (meningoencephalitits), [[loss of sensation]] ([[Radiculopathy|radiculopathies]] or [[neuritis]] involving the [[cranial]] or [[peripheral nerves]]) can be present in 2-7 percent of patients
* [[Cardiovascular]]: [[Chest pain]] is rare cardiovascular feature of brucellosis
* Ocular: Difficulty in [[vision]] and dimenision of vision
* Dermatology: [[Rash]], [[ulcer]] or [[Tenderness (medicine)|tender]] [[swelling]] can present with [[brucellosis]] upto 10 percent of patients
|-
|Relapse
|
* [[Relapse]] occurs in 5 to 15 percent of patient usually in first 6 months following treatment, although in rare cases it may even occur in up to 12 months of treatment.<ref>Ariza J, Bosilkovski M, Cascio A, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med 2007; 4:e317.</ref><ref>Ariza J, Corredoira J, Pallares R, et al. Characteristics of and risk factors for relapse of brucellosis in humans. Clin Infect Dis 1995; 20:1241.</ref>
* General well-being and changes in body [[weight]] help in diagnosis of relapse.
|-
|Chronic Brucellosis
|Presence of clinical manifestations for more then one year after established diagnosis of [[brucellosis]] is considered as chronic [[brucellosis]].
Clinical manifestations include:<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="pmid19420176">{{cite journal| author=Castaño MJ, Solera J| title=Chronic brucellosis and persistence of Brucella melitensis DNA. | journal=J Clin Microbiol | year= 2009 | volume= 47 | issue= 7 | pages= 2084-9 | pmid=19420176 | doi=10.1128/JCM.02159-08 | pmc=2708509 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19420176  }}</ref>
* [[Fatigue]]
* [[Arthralgia]]
* [[Malaise]]
* [[Myalgia]]
* [[Uveitis]]: patients complains of difficulty of [[vision]]
* [[Spondylitis]], [[Osteomyelitis|osteomyelitis,]] [[Arthralgias]]: patients complains of pain in joints or [[joint]] movement
* Intermittent [[sweating]]
|}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Latest revision as of 20:44, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Danitza Lukac Vishal Devarkonda, M.B.B.S[3]

Overview

Brucellosis can present with diverse clinical presentation which include systemic flu-like symptoms and symptoms due to focal involvement of organs by the bacteria.

Symptoms

Patients with brucellosis, can present with diverse clinical presentation which include systemic flu-like symptoms and symptoms due to focal involvement of organs by the bacteria:[1][2][3][4][5][6][7][8][9][10][11][12]

Brucellosis history and symptoms
Acute brucellosis Systemic symptoms

Focal organ wise symptoms:

Relapse
  • Relapse occurs in 5 to 15 percent of patient usually in first 6 months following treatment, although in rare cases it may even occur in up to 12 months of treatment.[13][14]
  • General well-being and changes in body weight help in diagnosis of relapse.
Chronic Brucellosis Presence of clinical manifestations for more then one year after established diagnosis of brucellosis is considered as chronic brucellosis.

Clinical manifestations include:[15] [16]

References

  1. ↑ Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 9th, 2017
  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. PMID 15930423. 
  5. ↑ 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.
  6. ↑ Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management.". Curr Clin Top Infect Dis. 15: 115–28. PMID 7546364
  7. ↑ Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.
  8. ↑ Zamani A, Kooraki S, Mohazab RA, Zamani N, Matloob R, Hayatbakhsh MR; et al. (2011). "Epidemiological and clinical features of Brucella arthritis in 24 children". Ann Saudi Med. 31 (3): 270–3. doi:10.4103/0256-4947.81543. PMC 3119967. PMID 21623056.
  9. ↑ 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
  10. ↑ 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. PMID 13130417. doi:10.1086/378125
  11. ↑ Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.
  12. ↑ Ariza J, Bosilkovski M, Cascio A, Colmenero JD, Corbel MJ, Falagas ME; et al. (2007). "Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations". PLoS Med. 4 (12): e317. doi:10.1371/journal.pmed.0040317. PMC 2222927. PMID 18162038.
  13. ↑ Ariza J, Bosilkovski M, Cascio A, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med 2007; 4:e317.
  14. ↑ Ariza J, Corredoira J, Pallares R, et al. Characteristics of and risk factors for relapse of brucellosis in humans. Clin Infect Dis 1995; 20:1241.
  15. ↑ Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management". Curr Clin Top Infect Dis. 15: 115–28. PMID 7546364.
  16. ↑ Castaño MJ, Solera J (2009). "Chronic brucellosis and persistence of Brucella melitensis DNA" Check |url= value (help). J Clin Microbiol. 47 (7): 2084–9. doi:10.1128/JCM.02159-08. PMC 2708509. PMID 19420176.
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