Brucellosis Overview and Epidemiology
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Questions and Answers

What laboratory finding is associated with brucellosis in approximately 50% of cases?

  • Increased platelet count
  • Severe anemia
  • Leucopenia below 4000
  • Lymphocytosis (correct)

Which test is indicated as suggestive of brucellosis when a titer of 1/160 is observed?

  • Serum agglutination test (correct)
  • Polymerase Chain Reaction (PCR)
  • Bone marrow culture
  • Blood culture

What treatment regimen is typically recommended for adults diagnosed with brucellosis?

  • Amoxicillin and Azithromycin
  • Ciprofloxacin and Metronidazole
  • Vancomycin and Gentamicin
  • Doxycycline and Rifampicin (correct)

What is the Prozone phenomenon in the context of brucellosis testing?

<p>False negative results despite culture positivity (C)</p> Signup and view all the answers

Which of the following symptoms is NOT typically associated with brucellosis?

<p>Acute abdominal pain (A)</p> Signup and view all the answers

What is the role of the 2-mercaptoethanol test in diagnosing brucellosis?

<p>To confirm a recent infection (D)</p> Signup and view all the answers

In which cases is a longer duration of treatment for brucellosis necessary?

<p>When joint, neurologic lesions, or endocarditis are present (C)</p> Signup and view all the answers

Which of the following conditions is considered a differential diagnosis for brucellosis?

<p>Cerebral malaria (C)</p> Signup and view all the answers

What is a common clinical manifestation of brucellosis during acute illness?

<p>Excessive sweating (A)</p> Signup and view all the answers

Which organ is most commonly involved in granuloma formation due to brucellosis?

<p>Spleen (C)</p> Signup and view all the answers

What is the typical incubation period for brucellosis?

<p>2-4 weeks (A)</p> Signup and view all the answers

Which of the following is NOT a typical complication of chronic brucellosis?

<p>Pneumonia (D)</p> Signup and view all the answers

Which symptom is likely indicative of localized infection in brucellosis?

<p>Papilledema (A)</p> Signup and view all the answers

Which of the following is commonly affected in joint infections due to brucellosis?

<p>Lumbar spine (C)</p> Signup and view all the answers

What percentage of patients with chronic brucellosis may experience symptoms for over a year?

<p>10% (B)</p> Signup and view all the answers

What is a possible outcome of brucellosis during pregnancy?

<p>Abortion (B)</p> Signup and view all the answers

What is a primary mode of transmission for brucellosis?

<p>Consumption of contaminated unpasteurized milk (C)</p> Signup and view all the answers

Which Brucella species is primarily associated with bovine reservoirs?

<p>Brucella abortus (D)</p> Signup and view all the answers

What is a common clinical manifestation of brucellosis?

<p>Joint and back pain (A)</p> Signup and view all the answers

What contributes to the chronic nature of brucellosis if not properly treated?

<p>Delayed diagnosis and treatment (D)</p> Signup and view all the answers

Which of the following is NOT a Brucella species known to cause infections in humans?

<p>Brucella canis (A)</p> Signup and view all the answers

Which antigen predominates in Brucella melitensis?

<p>M antigen (B)</p> Signup and view all the answers

What characteristic do Brucella bacteria possess?

<p>They are non-motile and intracellular pathogens (D)</p> Signup and view all the answers

What effect does pasteurization have on brucellosis transmission?

<p>It eliminates the bacteria (C)</p> Signup and view all the answers

Flashcards

Brucellosis

A bacterial infection that can cause fever, headache, fatigue, and muscle pain.

Intermittent fever

A symptom of brucellosis characterized by recurring episodes of fever.

Splenomegaly

An enlarged spleen, often associated with brucellosis.

Serum agglutination test

A blood test that measures the amount of antibodies in the blood. A high level of IgM antibodies suggests a recent infection, while a high level of IgG antibodies suggests a long-standing infection.

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Prozone phenomenon

The phenomenon where a high level of antibodies can make it difficult to detect the bacteria in a blood culture.

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PCR for Brucellosis

A lab test used to diagnose brucellosis by detecting the presence of Brucella DNA in blood or other samples.

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Streptomycin and Doxycycline

The most common combination of antibiotics used to treat brucellosis in adults.

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Cotrimoxazole and Rifampicin

The recommended treatment for brucellosis in children under 8 or pregnant women.

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Pathogenesis of Brucellosis

The process by which Brucella bacteria enter the body and cause disease. It involves phagocytosis by neutrophils and macrophages, leading to intracellular replication and dissemination.

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Granuloma Formation in Brucellosis

A characteristic inflammatory response in Brucellosis, typically occurring in organs like the liver and spleen, involving localized collections of immune cells.

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Arthritis in Brucellosis

A severe and disabling form of arthritis, often associated with Brucella melitensis infection.

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Epididymo-orchitis

Inflammation of the epididymis and testes, a common complication of Brucellosis, affecting around 5-9% of cases.

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Pyelonephritis and Glomerulonephritis

Inflammation of the kidneys, including both the renal pelvis and nephrons, can occur in Brucellosis.

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Chronic Brucellosis

A chronic form of Brucellosis persisting for 2 or more months in approximately 77% of cases.

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Incubation Period of Brucellosis

A period of 2-4 weeks between infection with Brucella and the onset of symptoms.

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Common Brucella Species

Brucella abortus, Brucella melitensis, and Brucella suis are the most common species responsible for Brucellosis in humans.

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Brucella Characteristics

Brucella bacteria are gram-negative, non-motile, and non-sporing. They are also intracellular pathogens, meaning they can live inside cells.

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Transmission of Brucellosis

Ingesting unpasteurized milk or dairy products, contact with infected animals, or handling contaminated animal products are common routes of transmission.

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Entry Points of Brucella

The bacteria enter the body through the digestive system, often via contaminated milk, and can also enter through cuts or abrasions.

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Acute vs. Chronic Brucellosis

Acute brucellosis is characterized by fever, chills, sweats, muscle aches, and joint pain. Chronic brucellosis can lead to complications including arthritis, endocarditis, and neurological disorders.

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Clinical Presentation of Brucellosis

Brucellosis is a possible diagnosis when patients present with unexplained fever, joint pain, and back pain, especially in areas where the disease is common.

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Treatment of Brucellosis

Treatment of Brucellosis usually involves a combination of antibiotics, such as doxycycline and rifampin, for several weeks.

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Study Notes

Brucellosis

  • A common occupational zoonotic illness
  • Caused by bacteria of the genus Brucella
  • Transmitted through contact with infected animals or animal products
  • Symptoms include fever, joint pain, back pain, and possible progression to chronic illness
  • Diagnosed through clinical presentation and laboratory tests
  • Treatment regimens vary, but may include antibiotics
  • Symptoms can be insidious or sudden onset
  • Manifestations can include swinging high temperatures, chills, sweating, headache, exhaustion, muscular pain, and constipation

Epidemiology

  • Infected animals are reservoirs of infection
  • Common animal reservoirs include cattle, goats, sheep, and pigs
  • Ingesting contaminated unpasteurized milk and products is a common route of transmission
  • Infected fluids and aerosols can transmit infection
  • Workers in microbiology labs, and those with occupations involving infected animals are at a higher risk of infection

Mode of Transmission

  • Ingestion of contaminated unpasteurized milk or dairy products
  • Close contact with infected animals (including ingestion of contaminated products such as placenta, carcasses, and milk)
  • Inhalation of contaminated aerosols
  • Handling infected materials in a lab setting

Pathogenesis

  • Brucella bacteria, after ingestion are capable of surviving through the stomach's acidic environment. Bacteria are then phagocytosed by neutrophils and macrophages which may then carry them to local lymph nodes where they replicate intracellularly
  • Bacteria can disseminate to other organs and tissues leading to inflammation and a range of clinical symptoms

Pathology

  • Granuloma formation in the liver and spleen

Clinical Manifestations

  • Acute illness may present with fever, chills, sweating, headache, lethargy, and muscular pains
  • Joint and bone involvement, including arthritis and vertebral infection
  • Localized infections, such as epididymitis and or orchitis
  • Possible neurologic involvement (e.g., meningoencephalitis)
  • Pregnancy complications, including spontaneous abortion and stillbirth.

Laboratory Findings

  • Normal or slightly decreased hemoglobin
  • Reduced leukocyte count
  • Reduced thrombocytes
  • Possible elevated transaminases
  • Increased alkaline phosphatase

Serology

  • Specific antibody tests help diagnose brucellosis (ELISA, agglutination)
  • Positive agglutination titer of 1/160 or higher is suggestive of active infection

Chronic Brucellosis

  • Persistent symptoms (fever, fatigue, or muscle pain) lasting for more than 2 months may suggest chronic brucellosis

Diagnosis

  • Includes clinical evaluation, blood culture, serological tests, bone marrow cultures

Treatment

  • Usually antibiotics such as doxycycline, streptomycin, and rifampicin
  • Duration of treatment varies based on the severity and site of infection
  • Treatment may need to be prolonged in patients with complications such as joint or neurological damage

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Description

This quiz covers key aspects of brucellosis, a zoonotic illness caused by Brucella bacteria. It includes information about symptoms, transmission routes, and risk factors associated with infection. Test your knowledge on the epidemiology and treatment of this occupational disease.

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