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Questions and Answers
What is the primary mode of transmission for brucellosis?
Which species are responsible for causing brucellosis in humans?
What is considered the gold standard for the definitive diagnosis of brucellosis?
Which occupation is at highest risk for contracting brucellosis?
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Which of the following is a common clinical manifestation of brucellosis?
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What type of bacteria is Brucella classified as?
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What is the recommended presumptive diagnosis titer for Brucella in endemic areas?
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Which of the following foods is most associated with the transmission of brucellosis?
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What additional complication is possible in untreated brucellosis patients?
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Which are the less hazardous dairy products for brucellosis transmission?
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Study Notes
Brucellosis: Definition and Transmission
- Zoonotic infection also known as undulant fever, Mediterranean fever, or Malta fever.
- Transmitted to humans from infected animals (cattle, sheep, goats, camels, pigs, etc.) through ingestion of contaminated food products (unpasteurized dairy products) or contact with infected tissues/fluids.
- Caused by Brucella species: Gram-negative coccobacilli, facultative intracellular aerobic rods, and the normal flora of the genitourinary tract in various animals. Four Brucella species cause human disease.
- Transmission primarily occurs via consumption of unpasteurized animal products, contact with infected animal tissue or fluids, or inhalation of aerosolized particles.
- Unpasteurized dairy products (raw milk, soft cheese, butter, ice cream) are the most common source. Hard cheese, yogurt, and sour milk pose less risk due to fermentation. Raw or undercooked meat is a less common transmission route.
- High-risk occupations include shepherds, veterinarians, dairy professionals, and laboratory personnel handling Brucella cultures or vaccines.
Clinical Manifestations and Complications
- Insidious onset with fever, weight loss, night sweats (often described as having a moldy odor), arthralgia, and headache.
- Physical findings may include lymphadenopathy, splenomegaly, and hepatomegaly.
- Brucella is taken up by lymphocytes, enters circulation via lymph nodes, and disseminates throughout the body.
- Complications can affect any organ system.
Diagnosis of Brucellosis
- Suspect brucellosis in patients with relevant signs, symptoms, and epidemiological exposure.
- Definitive diagnosis relies on culturing Brucella from blood, body fluids (urine, CSF, synovial fluid, pleural fluid), or tissue (bone marrow, liver biopsy). Bone marrow culture is more sensitive than blood culture. This method is time-consuming and potentially hazardous.
- Presumptive diagnosis uses serological tests, such as the standard tube agglutination test (SAT). A Brucella total antibody titer ≥1:160 is suggestive (sensitivity ~95%). In some endemic regions (e.g., Saudi Arabia), a titer of 1:320 may be considered.
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Description
Explore the zoonotic infection known as brucellosis, including its causes, transmission routes, and high-risk foods. This quiz covers important information about the Brucella species and preventive measures to avoid infection. Test your understanding of this significant public health concern.
