Brucellosis By: Wasil Aswadi, MD

1. Brucellosis
M. Wasil Aswadi

2. Contents
• Clinical features
• Physical findings
• Complications
• Diagnosis
• Treatment
• Prevention

3. Clinical features
• Protean in nature
• Not specific enough to support diagnosis
• Fever
– Associated with profuse sweats
– Almost invariable
– Associated with relative bradycardia
– Undulant
• Anorexia, asthenia, weakness

4. Clinical features
• Bone and joint symptoms
– Arthralgia
– Lower back pain
– Spine and joint pain
• Neuropsychiatric symptoms
– Headache, depression
– Changes in mental status, coma
• Gastrointestinal complaints
– Constipation, vomiting, diarrhea
– Abdominal pain
cont’

5. Physical findings
• Hepatosplenomegaly
• Right upper quadrant pain and jaundice
• Swelling, tenderness and limited motion of joints
• Swollen and tender scrotum
• New or changing murmurs, pericardial rub
• Respiratory depression, meningeal irritation

6. Physical findings
• Ocular findings
– Keratoconjunctivitis
– Optic neuritis
– Choroiditis
– Cataracts
• Cutaneous manifestations
– Vasculitic lesions
– Macular, maculopapular, scarlatiniform rashes
– Cutaneous ulcerations
cont’

7. Complications
• Rare if treated properly
• Relapse in 10% of patients
• Most common
– Osteoarticular
– Hepatobiliary and GI
– Genitourinary
– Neurobrucellosis
– Cardiovascular
• Less common
– Splenic abscess, epidural abscess

8. Diagnosis
• Complete blood count
– Neutropenia in a significant number of patients
– Anemia in 75% of patients
– Pancytopenia
• Culture
– Considered as one of the most definitive tests
– Recovered from blood, bone marrow or other tissues
• Serology
– The most commonly used method of diagnosing
– Tube agglutination test

9. Treatment
• Antibiotics
– Doxycycline
– Gentamicin, streptomycin
– Rifampin
– Trimethoprim-sulfamethoxazole
• Other agents
– Corticosteroids for symptomatic Brucella meningitis
– Analgesics and antipyretics

10. Prevention
• Eradication or control of disease in animals
• Better handling of infected animals
• Public awareness and education
• Immunization of at-risk animals
• Use of protective devices for people with an
occupational risk

11. Thank you