Brucellosis Questions & Answers

Updated: Apr 22, 2021
  • Author: Nicholas John Bennett, MBBCh, PhD, FAAP, MA(Cantab); Chief Editor: Michael Stuart Bronze, MD  more...
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Questions & Answers

Overview

What is brucellosis?

Which Brucella organisms have human pathogenicity?

In what types of animals is brucellosis found?

What is the global incidence of human brucellosis?

Why has the interest in brucellosis been increasing?

How is brucellosis diagnosed?

What are brucellae?

How is Brucella transmitted?

What is the pathogenesis of brucellosis?

How is Brucella able to activate the alternative complement system?

What percentage of brucellae are able to survive after ingestion?

Where in the body do brucellae replicate?

What is the host response to brucellae?

What provides immunity against Brucella reinfection?

What causes brucellosis?

Which Brucella species is most virulent in humans?

Which species is the most common cause of brucellosis infection in North America?

Which species is the second most common cause of brucellosis in North America?

Which species does not commonly cause chronic brucellosis?

Which Brucella species are found in marine animals?

What is the main route of transmission of B melitensis in humans?

Which groups are at highest risk of Brucella infection?

What would indicate release of a biologic weapon containing Brucella?

What is the incidence of brucellosis in the United States?

What is the cause of most human cases of brucellosis in the United States?

What is the global incidence of brucellosis?

What is the association between gross domestic product (GDP) and rates of brucellosis in Europe?

Which countries carry the heaviest brucellosis disease burden?

What is the incidence of brucellosis in endemic areas?

What was the WHO disability weight for brucellosis?

How does the incidence of brucellosis vary by age in different geographic locations?

Which ages are at highest risk of brucellosis?

How does brucellosis typically manifest in elderly individuals?

What is the prevalence of brucellosis in infants?

How does the incidence of brucellosis vary by sex?

Which factors increase the risk of brucellosis in men?

How does the incidence of brucellosis vary by race in the United States?

What is the prognosis of brucellosis?

What is the usual duration of brucellosis?

What is the mortality rate of brucellosis?

What can result from recurrent brucellosis?

What is psychoneurosis following treatment of brucellosis?

Which individuals are at higher risk for recurrence of brucellosis?

What is the duration for chronic brucellosis?

What information about brucellosis should patients be given?

Presentation

What is the focus of the medical history in suspected brucellosis?

What are the risk factors for brucellosis?

When should brucellosis be suspected?

Where is there a low threshold for consideration of brucellosis?

Why is dietary history important in suspected brucellosis?

What type of person-to-person transmission of brucellosis is possible?

How prevalent is lab transmission of brucellosis?

Where is a diagnosis of brucellosis more likely to be missed?

Why is dietary history important in suspected brucellosis in a region where the disease is not endemic?

What are the main reservoir hosts of brucellosis in North America?

How can brucellosis be transmitted to infants?

Which groups are at a high risk for brucellosis in nonendemic regions?

Which occupations are at greater risk for brucellosis?

What is the risk of Brucella being used as a biological weapon?

What are symptoms of brucellosis?

What is the most common symptom of brucellosis?

What are constitutional symptoms of brucellosis?

What are orthopedic symptoms of brucellosis?

What are neuropsychiatric symptoms of brucellosis?

What are GI symptoms of brucellosis?

What are genitourinary symptoms of brucellosis?

What are some neurologic symptoms of brucellosis?

What are pulmonary symptoms of brucellosis?

What are cardiac complications of Brucella infection?

What are the signs and symptoms of chronic brucellosis?

Which physical findings suggest brucellosis?

What are the classifications of brucellosis?

What is subclinical brucellosis?

What is acute and subacute brucellosis?

What is the presentation of acute brucellosis?

What are GI and lymphatic symptoms of acute brucellosis?

What are the indications of bacterial endocarditis in acute or subacute brucellosis?

What are the pulmonary symptoms of acute brucellosis?

What are the symptoms of neurobrucellosis?

What are the symptoms of brucellotic osteomyelitis?

How is chronic brucellosis diagnosed?

What are localized complications of brucellosis?

How is relapsing brucellosis differentiated from reinfection?

What are common physical findings in suspected brucellosis?

Which osteoarticular findings suggest brucellosis?

Which genitourinary findings suggest brucellosis?

Which cardiovascular findings suggest brucellosis?

What pulmonary findings suggest brucellosis?

What neurologic findings suggest brucellosis?

Which cutaneous findings suggest brucellosis?

Which ocular findings suggest brucellosis?

What are possible hepatobiliary complications of brucellosis?

What are pulmonary complications of brucellosis?

What are the common complications of brucellosis?

What are the less common complications of brucellosis?

How prevalent are osteoarticular complications of brucellosis?

What are possible genitourinary complications of brucellosis?

What is the prevalence of neurobrucellosis and how does it manifest?

What is the onset and duration of neurobrucellosis?

What are possible cardiovascular complications of brucellosis?

What are hematologic complications of brucellosis?

DDX

How specific are the signs and symptoms of brucellosis?

Which conditions should be included in the differential diagnoses of brucellosis?

What are the differential diagnoses for Brucellosis?

Workup

How is brucellosis diagnosed?

Which US agencies have regulations regarding specimens of Brucella?

Which countries outside the US have reporting requirements for Brucella?

What is the role of the complete blood count (CBC) in the diagnosis of brucellosis?

What is the role of liver enzymes testing in the diagnosis of brucellosis?

What is the sensitivity of blood cultures for diagnosis of brucellosis?

How long should brucellosis cultures be keep by the lab?

What is the role of bone marrow culture in the diagnosis of brucellosis?

What is the role of cerebrospinal fluid analysis in the diagnosis of neurobrucellosis?

What is the role of arthrocentesis in the diagnosis of brucellosis?

What is the role of serologic testing in the diagnosis of brucellosis?

What serologic finding is diagnostic of brucellosis?

What are limitations of agglutination tests for diagnosis of brucellosis?

What phenomenon my case a false-negative finding for brucellosis and how is it prevented?

What test is performed to diagnosis brucellosis relapse?

Which test is used for point of care diagnosis of brucellosis?

What is the role of PCR in the diagnosis of brucellosis?

What is the role of urine testing in the diagnosis of brucellosis?

What is the role of chest radiography in the diagnosis of brucellosis?

What is the role of spinal radiography in the diagnosis of brucellosis?

What is the role of ultrasonography in the diagnosis of brucellosis?

What is the role of radionuclide scintigraphy in the diagnosis of brucellosis?

What is the role of CT scanning in the diagnosis of brucellosis?

What is the role of bone marrow aspiration in the diagnosis of brucellosis?

What is the role of liver biopsy in the diagnosis of brucellosis?

Which histologic findings are characteristic of brucellosis?

Treatment

What is the goal of medical therapy for brucellosis?

How is brucellosis treated?

When is specialized care indicated for brucellosis?

What is the focus of EMS care for brucellosis?

If a bioterrorist attack using brucellosis occurs, what precautions are required?

What precautions should be taken during the treatment of brucellosis by healthcare provider?

What is the vaccine strategy employed against Brucella?

Which antibiotics are used in the treatment of brucellosis?

Which nonantibiotic agents are used in the treatment of brucellosis?

What is the optimal antibiotic therapy for brucellosis?

What is the role of doxycycline in the treatment of brucellosis?

What are the WHO recommendations for treatment of acute brucellosis?

What is the efficacy of combined doxycycline and streptomycin for the treatment of brucellosis?

How is brucellosis treated in children younger than 8 years old?

How is brucellosis treated during pregnancy?

How is brucellosis treated when spondylitis or sacroiliitis is comorbid?

What are the treatment options for neurobrucellosis?

How is meningitis treated in patients with brucellosis?

What is the basis for treatment selection in acute brucellar meningoencephalitis?

What is the treatment for endocarditis in patients with brucellosis?

What is the role of corticosteroids in the treatment of brucellosis?

When is surgery indicated for the treatment of brucellosis?

What diet and activity modifications are beneficial in the treatment of brucellosis?

How is brucellosis prevented?

What education should individuals be given about brucellosis prevention?

What is the role of hygiene in the prevention of brucellosis?

What is the immunization strategy for prevention of brucellosis?

What prevention measures should be implemented for individuals with an occupational risk for brucellosis?

How can Brucella be weaponized?

What are the BICHAT treatment guidelines for a Brucella bioterrorist exposure?

Which specialist consultation is needed in the diagnosis and management of brucellosis?

Which specialist consultation is helpful in the treatment of brucellosis?

What monitoring is needed during the treatment of brucellosis?

What follow-up care is needed after brucellosis treatment is completed?

How is relapse differentiated from reinfection of brucellosis?

What is infection-induced hypersensitivity to Brucella agents?

Medications

Which drugs display activity with low relapse rates against Brucella species?

Which medications in the drug class Corticosteroids are used in the treatment of Brucellosis?

Which medications in the drug class Antibiotics, Other are used in the treatment of Brucellosis?