Podcast
Questions and Answers
Which serotype of Brucella primarily infects cattle?
Which serotype of Brucella primarily infects cattle?
What is one of the causes of chronicity in brucellosis?
What is one of the causes of chronicity in brucellosis?
Which test is associated with the primary IgM response in brucellosis?
Which test is associated with the primary IgM response in brucellosis?
What type of fever is commonly associated with acute brucellosis?
What type of fever is commonly associated with acute brucellosis?
Signup and view all the answers
Which complication is frequently observed in chronic cases of brucellosis?
Which complication is frequently observed in chronic cases of brucellosis?
Signup and view all the answers
Which of the following is a common cause of death associated with brucellosis?
Which of the following is a common cause of death associated with brucellosis?
Signup and view all the answers
What is a significant investigation for diagnosing brucellosis?
What is a significant investigation for diagnosing brucellosis?
Signup and view all the answers
Which treatment regimen has the highest relapse rate in brucellosis?
Which treatment regimen has the highest relapse rate in brucellosis?
Signup and view all the answers
What is an effective prevention measure against brucellosis?
What is an effective prevention measure against brucellosis?
Signup and view all the answers
What neurological manifestation is associated with neurobrucellosis?
What neurological manifestation is associated with neurobrucellosis?
Signup and view all the answers
Study Notes
Brucellosis
- Caused by Brucella group of organisms.
- Gram-negative aerobic cocco-bacilli.
- 3 serotypes infect humans.
Serotypes
-
B. abortus → cattle
-
B. melitensis → goats and sheep
-
B. suis → pigs
-
Brucella possesses two antigens:
- A → B. abortus and B. suis
- M → B. melitensis
Transmission
- A zoonotic and occupational disease.
- Transmission routes include:
- Gastrointestinal tract (GIT)
- Direct contact
- Respiratory tract
- Congenital
- Human milk
- Infected blood
Pathology
- Infection involves the nasopharynx or GIT, leading to regional lymph nodes and the reticuloendothelial system (RES).
- Brucella organisms are strictly intracellular, explaining the chronic and treatment-resistant nature of the infection.
- Two types of reactions occur:
- Hypersensitivity reaction →granulomas
- Antibody reaction → primary (IgM) response (e.g., Widal test) or secondary (IgG) response (e.g., Coomb's test)
- Mononuclear cells distortion and rupture exhibit periodicity.
Presentation
- Incubation period (IP) is 2-4 weeks.
-
- Asymptomatic
-
- Acute onset (rapid or insidious) with nonspecific symptoms such as fever, drenching sweats, headache, arthralgia, and arthritis (especially back tenderness).
Clinical Features
- Fever (stepladder, intermittent, periodic, 2-4 weeks per cycle).
- Splenomegaly (27-50%).
- Lymphadenopathy.
- Chronic cases show nonspecific symptoms like headache, sweating, backache, mental symptoms, and hepatosplenomegaly (always present).
Complications
- Skeletal involvement → predilection for the lumbar region, destruction of vertebrae and intervertebral discs, leading to sciatica, cauda equina lesions, paraplegia, sacroilitis (common).
- Brucella endocarditis → serious (affecting aortic and mitral valves).
- Liver abscesses
- Central Nervous System (CNS) involvement → neurobrucellosis (depression, suicidal tendencies).
- Genitourinary (GU) tract involvement → orchitis and pyelonephritis.
Causes of Death
- Suicide
- Infective endocarditis
- Liver failure
Investigations
- General investigations:
- Normocytic normochromic anemia
- White blood cell count (WBC) normal or reduced
- Elevated erythrocyte sedimentation rate (ESR)
- Liver function tests (LFT) normal or elevated
- Specific investigations:
- Isolation of organism from blood (difficult, 4-6 weeks to get result, 10-85% positivity).
- Bone marrow (BM) culture (90%).
- Organism isolation from urine, pus, or cerebrospinal fluid (CSF) (45%).
- Liver biopsy (microgranulomas)
- Widal test (detects IgM for recent infection).
- Coomb's test (detects IgG and not indicative of recent infection).
- ELISA (distinguishes between IgM and IgG).
- Polymerase Chain Reaction (PCR) (detects Brucella antigen).
- Brucella skin test.
Treatment
- Standard treatment options:
- Streptomycin (STM) 1g for 2-3 weeks + doxycycline 100 mg twice daily for 6 weeks (6% relapse rate)
- Rifampicin 600mg before breakfast for 6 weeks + doxycycline 100 mg twice daily for 6 weeks (14% relapse rate)
- Cotrimoxazole + Gentamicin (safe during pregnancy: Rifampicin 600mg daily x 6 weeks)
Prevention
- Boil or pasteurize milk.
- Avoid raw milk products.
- Vaccinate animals.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Test your knowledge on Brucellosis, its causative agents, transmission routes, and pathology. This quiz covers various aspects of the disease, including the serotypes of Brucella and their effects on humans. Dive into the details of this zoonotic infection and learn more about its clinical relevance.
