Brucellosis

Last Updated: 2020-08-12

Author(s): -

  • Marston 1861
  • Bruce 1887
  • Brucella melitensis: Malta fever, Mediterranean fever, Febris undulans melitensis, Febris mediterranea,
  • Wave fever, Bruce septicaemia
  • Brucella abortus: Febris undulans bovina
  • Brucella suis (pig brucellosis suis): the main host is the pig

Notifiable infection with Brucella, small gram-negative rod bacteria.

  • Veterinarians, animal keepers and workers in the meat industry are particularly affected
  • Brucella melitensis: Mediterranean, Africa, South America
  • B. abortus: occurs worldwide, especially in warm and tropical areas where cattle breeding is practised
  • B. suis: North America
  • Pathogen
    • In particular Brucella melitensis, B. abortus, B. ovis, B. suis
  • Hosts
    • Brucella melitensis: goats (Malta fever)
    • B. abortus: cattle (M. Bang)
    • B. ovis: Sheep
    • B. suis: pigs ( pig brucellosis)
  • Transmission
    • Through contaminated food (raw milk), smear infection or direct contact with animals (cattle, pigs, goats, sheep), inhalation, transmission from person to person is unusual

  • Incubation period: 2-6 weeks
  • The pathogens nest in the macrophages and in the reticuloendothelial system. Exotoxins then trigger disease symptoms. After the stage of bacteremia with undulating fever, development of granulomatous inflammation, especially in lymph nodes, spleen and liver, and arthritis of the ileosacral, intervertebral and hip joints.
  • Non-specific prodromal stage
  • Stage of bacteremia: Chronic recurrent fever attacks (Febris undulans) often lasting for months. Wavelike temperature rise and fall over 5-7 days
  • Additional symptoms are cephalgias, nausea, vomiting, diarrhoea, hepatosplenomegaly, maculopapular, partly EEM-like exanthema
  • Granuloma formation in multiple organs
  • Skin: ulcerating, ecthymata-like nodules
  • Medical history (contact with animals? drunk raw milk? travel history)
  • Pathogen detection (Bact. smear, blood, sample biopsy)
  • Serological antibody detection
  • With delayed diagnosis and therapy often recurrence and chronic course
  • Recurrence does not automatically mean resistance to antibiotics

If therapy is started early, the chances of recovery are almost 100%, otherwise chronic, years-long progressions can occur.

General measures

  • Duty to report!

Systemic therapy:

  • Refer to infectiology. Doxycycline and Rifampicin are typically used, Cotrimoxazole in children.
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