Brucellosis natural history, complications and prognosis: Difference between revisions
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==Complications== | ==Complications== | ||
** | {| class="wikitable" | ||
! colspan="2" |Complications of Brucellosis | |||
|- | |||
|'''Osteoarticular''' | |||
| | |||
*Most frequent complications | |||
*Occur in approximately 40% of cases. | |||
*[[Sacroiliitis]] | |||
**Most common complication | |||
*[[Bursitis]] | |||
*Peripheral [[arthritis]] | |||
*[[Osteomyelitis]] | |||
*[[Tenosynovitis]] | |||
*[[Spondylitis]] | |||
|- | |||
|'''Cardiovascular''' | |||
| | |||
*[[Infective endocarditis]] | |||
**Common cardiovascular complication | |||
**Frequent cause of death | |||
**It has been reported in approximately 2% of cases | |||
**The [[aortic valve]] is more commonly affected than the [[mitral valve]] | |||
**[[Valve]] replacement [[surgery]] is usually needed apart from the medical therapy | |||
*[[Aneurysm of sinus of valsalva]] | |||
**Common complication when [[infection]] is due to ''B. suis'' | |||
|- | |||
|'''Hepatobiliary complications''' | |||
| | |||
*[[Granulomatous hepatitis]] | |||
**Due to ''[[Brucella abortus|B. abortus]]'' | |||
*Post-necrotic [[cirrhosis]] | |||
**Very rare | |||
* Chronic suppurative lesions and [[Hepatic abscess|hepatic abscesses]] | |||
**Due to B. suis | |||
|- | |||
|'''Genitourinary''' | |||
|[[Orchitis]] and [[epididymitis]] | |||
*Frequent [[Genitourinary system|genitourinary]] complications within men | |||
|- | |||
|'''Neurological''' | |||
| | |||
*[[Meningitis]] or [[meningoencephalitis]] | |||
**Most common frequent complications of neurobrucellosis | |||
*[[Brain abscess|Brain]] and [[epidural abscess]] | |||
*[[Cerebellar ataxia]] | |||
*[[Cerebral vasculitis]] | |||
*[[Guillain-Barré syndrome]] | |||
*[[Haemorrhage]] | |||
*[[Mycotic aneurysm]] | |||
*[[Stroke]] | |||
*[[Neuropathy]]/[[radiculopathy]] | |||
*[[Poliomyelitis]]-like syndrome | |||
|- | |||
|'''Gastrointestinal''' | |||
|[[Colitis]], [[ileitis]], and [[spontaneous bacterial peritonitis]]. | |||
*Rare cases have been reported. | |||
|- | |||
|'''Respiratory tract''' | |||
| | |||
*[[Bronchopneumonia]] | |||
*[[Empyema]] | |||
*[[Hilar]] and [[Paratracheal lymph nodes|paratracheal lymphadenopathy]] | |||
*[[Interstitial pneumonitis]] | |||
*[[Lung nodule|Lung nodules]] | |||
*[[Pleural effusions]] | |||
|- | |||
|'''Pregnancy''' | |||
|[[Spontaneous abortion]] | |||
|- | |||
|'''Cutaneous''' | |||
| | |||
*[[Erythema nodosum]] | |||
*[[Nodules]] | |||
*[[Papules]] | |||
*[[Petechiae]] | |||
*[[Purpura]] | |||
*[[Rashes]] | |||
*[[Abscesses]], cutaneous ulcers, and [[suppurative]] [[lymphangitis]] | |||
**Common complication when infection is due to ''B. suis'' | |||
|- | |||
|'''Opthalmic''' | |||
|[[Uveitis]] | |||
*Most frequent ophtalmic complications<ref name="abc" /> | |||
|} | |||
==Prognosis== | ==Prognosis== | ||
*The mortality of the disease in 1909, as recorded in the British Army and Navy stationed in Malta, was 2%. | *The mortality of the disease in 1909, as recorded in the British Army and Navy stationed in Malta, was 2%. | ||
Revision as of 17:25, 4 January 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Danitza Lukac
Overview
If left untreated, patients with brucellosis may progress to develop focal infections, relapses or chronic brucellosis.[1] Common complications of brucellosis include granulomatous hepatitis, arthritis, sacroiliitis, meningitis, orchitis, epididymitis uveitis, and endocarditis. The prognosis of brucellosis is good with adequate treatment. Relapse may occur, and symptoms may continue for years.[1][2][3]
Natural History
- Brucellosis incubation period is 2–4 weeks (range, 5 days to 5 months).
- Initial presentation is nonspecific, including fever, muscle aches, fatigue, headache, and night sweats.
- If left untreated, patients with brucellosis may progress to develop focal infections, relapses or chronic brucellosis.[4]
Complications
| Complications of Brucellosis | |
|---|---|
| Osteoarticular |
|
| Cardiovascular |
|
| Hepatobiliary complications |
|
| Genitourinary | Orchitis and epididymitis
|
| Neurological |
|
| Gastrointestinal | Colitis, ileitis, and spontaneous bacterial peritonitis.
|
| Respiratory tract | |
| Pregnancy | Spontaneous abortion |
| Cutaneous |
|
| Opthalmic | Uveitis
|
Prognosis
- The mortality of the disease in 1909, as recorded in the British Army and Navy stationed in Malta, was 2%.
- The most frequent cause of death was endocarditis.
- Recent advances in antibiotics and surgery have been successful in preventing death due to endocarditis.
- Relapse may occur, and symptoms may continue for years. Brucellosis can come back after a long period of time.[1][3]
Reference
- ↑ 1.0 1.1 1.2 Brucellosis. CDC. http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/brucellosis. Accessed on February 3, 2016
- ↑ 2.0 2.1 FAO/WHO/OIE Brucellosis in humans and animals. WHO (2006). http://www.who.int/csr/resources/publications/Brucellosis.pdf Accessed on February 3, 2016
- ↑ 3.0 3.1 Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 1, 2016
- ↑ Brucellosis. CDC. http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/brucellosis. Accessed on February 3, 2016