Brucellosis

• 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 (porcine brucellosis = brucellosis suis): main host is the pig

Notifiable infection with brucella, small gram-negative rod-shaped bacteria.

• Specially veterinarians, animal caretakers and workers in the meat industry affected
• Brucella melitensis: Mediterranean region, Africa, South America
• B. abortus: Occurring worldwide, especially in temperate and tropical areas where cattle farming is practised
• B. suis: North America

• Exciter
  • 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 (porcine brucellosis)
• Transmission
  • Through contaminated food (raw milk), smear infection or direct contact with animals cattle, pigs, goats, sheep), inhalation, human-to-human transmission is uncommon
• Incubation period: 2-6 weeks
• The pathogens nest in the macrophages and reticuloendothelial system. Exotoxins then trigger symptoms of disease. After the stage of bacteraemia with undulating fever, formation of granulomatous inflammation mainly in lymph nodes, spleen and liver, and arthritis of the ileosacral, intervertebral and hip joints.

• Unspecific prodromal stage
• Stage of bacteraemia: Chronic recurrent episodes of fever (febris undulans) often over months. Wavelike rise and fall of temperature over 5-7 days
• Additional findings include cephalgia, nausea, vomiting, diarrhoea, hepatosplenomegaly, maculopapular, sometimes EEM-like exanthema
• Granuloma formation in multiple organs
• Skin: ulcerative, ecthyma-like nodules

• Anamnesis (contact with animals? raw milk drunk? travel history)
• Detection of pathogens (bacterial smear, blood, sample biopsy)
• Serological antibody detection

• If diagnosis and therapy are delayed, recurrence and chronic course are frequent
• Recurrence does not automatically mean antibiotic resistance

If treatment is started early, the chances of cure are almost 100%, otherwise the disease progresses chronically for years.

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