BRUCELLOSIS

DR. FAISAL HADDADConsultant of Family Medicine

&Occupational Health

PSMMC

HISTORY

BACKGROUND

Brucellosis is a worldwide zoonosis caused by the bacterial genus Brucella. These organisms localize in the reproductive organs of host animals, causing abortions and sterility.

They are shed in large numbers in the animal's urine, milk, and placental fluid.

Exposure to infected animals and animal products causes the disease in humans.

Seroprevalence of brucellosis in KSA

Patients and Methods: A natural survey of 23,613 subjects was conducted in 1997, in order to assess the seroprevalence of brucellosis in Saudi Arabia. Investigations included interviews, clinical examination and blood sampling for antibody determination, using the standard tube agglutination test (STAT).

Results: the seroprevalence of brucellosis was 15%. The seroprevalence increased by age, and was higher in rural areas, and among people in high-risk occupations.

CLASSIFICATION OF BRUCELLA

ORGANISMANIMAL

RESERVOIRGEOGRAPHIC DISTRIBUTION

B melitensis Goats, sheep, camels

Mediterranean, Asia, Latin America, Africa

B abortus Cows, buffalo, camels, yaks

Worldwide

B suis Pigs South America, Southeast Asia, USA

Brucella canis Canines Cosmopolitan

MODE OF TRANSMISSION

Consumption of infected, unpasteurized animal-milk products.

Direct contact with infected animal parts.

Inhalation of infected aerosolized particles.

Consumption of meat of infected animal ???

CLINICAL MANIFESTATIONS

HX Generally nonspecific Fever Malodorous perspiration Constitutional symptoms

O/E Generally nonspecific Lymphadenopathy Hepatomegaly or spleenomegaly

COMPLICATIONS (MOST COMMON)

1. Osteoarticular disease Peripheral arthritis Sacroiliitis Spondylitis

2. Reproductive system disorders Epididymoorchitis Spontaneous abortion

3. Hepatitis

4. Pancytopenia

COMPLICATIONS (LESS COMMON)

Central nervous system disorders

e.g meningitis, encephalitis, brain abcess.

Endocarditis

Respiratory disorders

e.g lobar pneumonia, pleural effusion.

Every organ and system of the human body can be affected.

RELAPSE

Relapses usually occur at a rate of about 10 % , in the first year after infection.

Often milder in severity than the initial disease, and can be treated with a repeated course of the usual antibiotic regimens.

Most cases of relapse are caused by :

1. Inadequate treatment.

2. Associated with characteristics of the initial infection that include a duration of < 10 days, male sex, bacteremia, and thrombocytopenia.

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