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Brucellosis
Pharmacotherapeutic
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)
Other name
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.
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
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
Risk group
• Cattle ranchers/ dairy /pig/sheep and goat farmers
• Veterinarians
• Meat inspectors & Lab workers
• Consumers of unpasteurized dairy products
Pathogenesis
Clinical features
Diagnosis
• Physical examination
Differential diagnosis
• Fever of unknown origin
• Malignancy (eg, lymphoma)
• Rickettsial diseases
• Sacroiliitis
• Vasculitis
Non pharmacological management
• Bed rest
• Increase semisolid food
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.
Complications
Prevention
Vaccination again B. abortus

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brucellosis.pptx

  • 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)
  • 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
  • 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.