brucellosis pathophysiology

1. Brucellosis
Pharmacotherapeutic

2. Introduction
• Brucellosis is considered as one of the most wide spread zoonosis in
the world.
• It causes severe hazard to human health, through either direct
contact with infected animals or the consumption of contaminated
milk and dairy products.
• In Nepal, brucellosis was first reported in 1977
• Incubation: 1-3 week (sometime few months)

3. Other name

4. Etiology/Transmission
• Brucella. abortus (cattle)
• B. melitensis (sheep & goats)
• B. ovis (sheep)
• B. suis (pigs)
• B. canis (dogs)
• B. neotomae (wood rat)
• Brucella are small (0.4-0.8 ×0.5-1.5μm), non-motile, non - capasulate,
gram-negative coccobacilli.

5. Transmission in animals
• Ingestion of infected tissues or body fluids, contaminated feed or
water, or after licking an infected placenta, foetus or genitalia of
another cow, after it has aborted.
• Infected bulls may excrete the organism in their semen.
• Congenital transmission may occur through in utero infection.
• Contact with infected tissues or body fluids: Mucous membranes,
injections

6. Transmission in human
• Conjunctiva or broken skin contacting infected tissues - Blood, urine,
vaginal discharges, aborted fetuses, placentas
• Ingestion -Raw milk & unpasteurized dairy products
• -Rarely through undercooked meat Inhalation of infectious aerosols

7. Risk group
• Cattle ranchers/ dairy /pig/sheep and goat farmers
• Veterinarians
• Meat inspectors & Lab workers
• Consumers of unpasteurized dairy products

8. Pathogenesis

9. Clinical features

10. Diagnosis
• Physical examination

11. Differential diagnosis
• Fever of unknown origin
• Malignancy (eg, lymphoma)
• Rickettsial diseases
• Sacroiliitis
• Vasculitis

12. Non pharmacological management
• Bed rest
• Increase semisolid food

13. Pharmacological management
• For simple infection : Doxycycline 100 mg BD or combination with
rifampiin 400 -600 mg daily for 6 weeks
• For acute case: (Children above 8 years)
• Combination of doxycycline 100 mg BD and rifampin 600-900 mg daily
for 6 weeks
• Doxycycline 100 mg PO twice daily for 6 weeks and streptomycin 1
g/day IM for 2-3 weeks
• Children below 8 years
• rifampin and trimethoprim –sulfamethoxazole (80/400) for 6 weeks
• Chronic case:
• Combination of rifampin, doxycycline, and streptomycin.

14. Complications

15. Prevention
Vaccination again B. abortus