1 / 13

Brucellosis

Brucellosis. Sung Chul Hwang, M.D. Dept of Pulmonary and Critical Care Medicine Ajou University School of Medicine. Introduction. Also called undulant, Mediteranean , or Malta fever Zoonotic infection Four species : abortus(cattle) melitensis (goats and sheep) suis(swine)

gema
Télécharger la présentation

Brucellosis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Brucellosis Sung Chul Hwang, M.D. Dept of Pulmonary and Critical Care Medicine Ajou University School of Medicine

  2. Introduction • Also called undulant, Mediteranean , or Malta fever • Zoonotic infection • Four species : abortus(cattle) melitensis (goats and sheep) suis(swine) canis(dogs)

  3. Febrile patterns of Brucellosis(Undulant fever)

  4. Epidemiology • Direct inoculation through cuts and abrasions • Via conjunctiva • Inhalation of aerosols • Ingestion of contaminated food • Venereal transmission has been suggested

  5. Pathogenesis • Invasion of bodyphagocytized by PMN or Macrophages spread to regional L/Ns Blood stream formation of granulomas with epitheloid cells, giant cells, lymphocytes and plasma cells in liver and RES

  6. Acute Brucellosis • Incubation 7 to 21 days to months • Insidious onset of low grade fever, and no localizing complaints • Anorexia, sweats, chills, weight loss, headache, backache, arthralgia • Multiple complaints but a few physical findings • Splenomegally (10-20%), lymphadenopathy(15%), hepatomegaly(10%)

  7. Localized Brucellosis • Any anatomic locations • Osteomyelitis, splenic abscess, GU tract infections, pulmonary infection, endocarditis(most common cause of mortality)

  8. Chronic Brucellosis • Malaise asthenia, depression, chronic fatigue syndrome- like presentation • Ill health of more than 1 year of following onset Brucellosis • Mixed manifestations: • relapsing illness with or without localizing infection, • patients with no objective signs of infections, • no evidence of active Brucellosis by serology or culture

  9. Diagnosis • Clinical suspicion in chronic fever and non-specific complaints • Routine Lab. and X-rays : non-specific • Cultures: Blood, Bone Marrow, or liver biopsy in initial stage , but only 15 to 20% positive slow growth biphasic media • (Ruiz-Castaneda) : 7 – 21 days to 35 days but usually Bactec culture system only grow it for 7 days then discard

  10. Serologic Tests for Brucellosis • Serum Agglutination ( Standard Tube Assay) : > 1: 160 or 4 fold increased titer • Complement fixation • Rose Bengal Agglutination • Antibrucella Coombs • ELISA

  11. Treatment of Brucellosis • Choice : Tetracycline 30 mg/kg/day gor 3 to 6 weeks + SM 15mg/kg q 12hrs for first 2 weeks • Alternative : Tetracycline (or doxycycline plus GM or Rifampin • Endocarditis : Antibiotics + Valve replacement

  12. Prognosis • Mortality < 5 % < 2 % with antibiotics • Endocarditis is the most common cause of Mortality

  13. Prevention • Immunization of animals with live attenuated vaccine • No vaccine available for human • Pasteurization of the milk products • Avoid contacts and exposure by protective garments and gloves

More Related