brucellosis
TRANSCRIPT
BRUCELLOSIS (highly contagious zoonosis.)
By: DR. SAURAV POUDEL 26th October 2016
Brucellosis
• Other name:- undulant fever- Malta fever - Mediterranean fever.
- It is a major bacterial zoonoses caused by different species of the Brucella group of organism and characterized by intermittent or irregular febrile attacks, with profuse sweating ,arthritis and splenomegaly.
Brucellosis
- Agent :i. Brucella melitensis: most invasive and
virulent.ii. Brucella abortus : less virulent.iii. Brucella suis : intermediate virulent.iv. Brucella canis: parasite of dogs.
• Modes of transmission : transmission is usually from infected animal to man. There is no evidence of transmission from man to man. The routes are:
a. Direct contact with infected tissues,blood,urine & vaginal discharges.
b. Ingestion of raw milk or daily products from infected animals.
c. Inhalation of infected dusts or aerosols.
• Incubation periods : usually 1-3 weeks.
• Clinical features :
-Swinging pyrexia (40-41 degree Celsius) with rigors and sweating.
-Arthralgia, arthritis.-Low back pain.-Headache; insomnia.-Splenomegaly.-Hepatomegaly.-Lymphadenopathy.
Investigation
• Full blood count : -leucopenia with relative lymphocytosis. -ESR raised - pancytopenia.• Liver function test.• Culture : blood 75-80% positive, bone marrow lymph node.• Serology : IgM antibody 1st week, IgG Ab. > 3 weeks
• Agglutination test : IgG titre >1:80
• D/D: - malaria -kalazar - typhoid fever -tuberculosis.• Treatment :I. General measures :- Rest- Diet : high calorie diet- Fluid and electrolyte balance- Bowel/bladder care
II. Specific treatment :-Doxycycline 100 mg twice daily for 6 weeks.-Streptomycin 1 gm IM 2 weeks. OR Doxycycline 100 mg twice daily + Rifampicin
900 mg daily for 6 weeks.
• Complication :-Osteomylitis.-Septic arthritis-meningoencephalitis.-splenic,liver abscess-bacterial endocarditis.
