Symptoms of brucellosis may occur anytime from 5 days to 5 months after initial exposure to Brucella species; symptoms may also disappear for weeks or motnhs only to return at a later date.
See a GP if you have symptoms of brucellosis and:
you've had unpasteurised milk or dairy products. you've eaten raw or undercooked meat. you work closely with farm animals.
Brucellosis can be diagnosed in a laboratory by finding bacteria in samples of blood, bone marrow or other bodily fluids. Serological tests can also be done to detect antibodies against the bacteria.
There are various assays available for the diagnosis of Brucella infection, including molecular, serological, and microbiological tests. Culture is the gold standard method for Brucella detection, but the sensitivity of blood culture had a wide range, from 10% to 90% [7].
Fever is the most common symptom and sign of brucellosis, occurring in 80-100% of cases.
In the first stage of the disease, bacteremia occurs and leads to the classic triad of undulant fevers, sweating (often with a characteristic foul, moldy smell sometimes likened to wet hay), and migratory arthralgia and myalgia (joint and muscle pain).
Hematological inflammatory markers of brucellosis include mean platelet volume (MPV), red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR).
In this test, a Brucella antigen stained with hematoxylin is added to milk. Any agglutinins in the milk, which are carried by the cream as it rises to the surface, react with the antigen. Clumping follows, and a blue ring, indicative of the presence of brucellae, is formed.
Differential Diagnosis
Epstein bar virus infectious mononucleosis. Infective endocarditis. Influenza. Leptospirosis.
Brucellosis can affect almost any part of your body, including your reproductive system, liver, heart and central nervous system. Chronic brucellosis may cause complications in just one organ or throughout your body. Possible complications include: Inflammation of the inner lining of the heart chambers (endocarditis).
The tube agglutination test, developed by Bruce, measures antibodies against smooth lipopolysaccharide (LPS); it remains the most popular test tool for the diagnosis of brucellosis.
For acute brucellosis in adults and children older than 8 years, the World Health Organization (WHO) guidelines recommend the following: Doxycycline 100 mg PO twice daily plus rifampin 600-900 mg/day PO – Both drugs are to be given for 6 weeks; this regimen is more convenient but probably increases the risk of relapse.
This is a serious zoonotic disease causing illness in people. Brucella abortus no longer occurs in Australia as a result of a national eradication program between 1970 and 1989. Brucella ovis infection causes disease and infertility in sheep, but does not affect people.
This is a blood test for brucellosis. Brucellosis is an infectious disease usually caused by handling animals or milk products infected with the brucella bacteria. If you have brucellosis, your body will make certain antibodies to fight the brucella bacteria. This test looks for those antibodies in your blood.
Rose Bengal is a rapid plate agglutination test that uses a suspension of Brucella abortus in an acid buffer. It is able to detect agglutinating and nonagglutinating antibodies, and avoids the prozone phenomenon.
The Milk Ring Test (MRT) can be used to detect Brucella antibodies in tank milk if the following points are considered: (1) Before testing, the milk must be stored at least 72 hours at 6 degrees C. (2) To obtain a reliable reaction one must use 8 ml milk and 0.8 ml antigen, instead of 1 ml milk and 0,05 ml antigen.
A diagnosis of brucellosis is confirmed by the isolation of small Gram-negative cocco-bacilli from blood or other tissues, a suitable history and confirmed by specific biochemical tests. Biotyping at a reference laboratory can provide additional information on the aetiology of the isolate.
An abnormal (positive) result usually means you have come in contact with the bacteria that causes brucellosis. However, this positive result does not mean that you have an active infection. Your provider will have you repeat the test after a few weeks to see if the test result increases.
The histologic features of brucellosis lymphadenopathy resemble those of cat-scratch disease and are characterized by reactive follicular hyperplasia, lipid-laden (foamy) macrophages with loose granuloma formation, and areas of microabscesses.
White blood cell count is normal or is reduced among most of Brucellosis patients, accounting for 90.73% (137/151); the patients whose eosinophils are reduced account for 75.50% (114/151) and those whose eosinophils disappear are about 18.54% (28/151).
Symptoms begin as an acute febrile illness with few or no localized signs and may progress to a chronic stage with relapses of fever, weakness, sweats, and vague aches and pains. Diagnosis is by culture, usually from the blood.
Brucellosis infection of the central nervous system (CNS) is a rare but severe complication [2, 3] and the varied clinical manifestations, including confusion, meningoencephalitis, myelitis, peripheral or cranial neuropathies, and psychiatric manifestations, make the diagnosis challenging.
High fever, hydrolysis, fatigue and arthralgia of the large joints are the main symptoms of brucellosis. Brucellosis can also mimic various multisystem disease and cause multiple complications, such as those of the musculoskeletal system, hematological system, digestive system, nervous system and urinogeenital system.
Brucellosis typically causes flu-like symptoms, including fever, weakness, malaise and weight loss. However, the disease may present in many atypical forms. In many patients the symptoms are mild and, therefore, the diagnosis may not be considered.