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__NOTOC__
__NOTOC__
{{Brucellosis}}
{{Brucellosis}}
{{CMG}}; {{AE}} {{RT}} {{DL}}
{{CMG}}; {{AE}} {{RT}} {{VD}}


==Overview==
==Overview==
Symptoms of brucellosis include [[undulant fever]], [[night sweats]] (with characteristic smell, likened to wet hay), and [[joint pain]].<ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 4, 2016</ref>
Brucellosis can present with diverse clinical presentation, which include systemic flu-like symptoms and symptoms due to focal involvement of organs


==Symptoms==
==Symptoms==
Patients with Brucellosis, can present with diverse clinical presentation, which include systemic flu-like symptoms and symptoms due to focal involvement of organs:<ref>Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75:195.</ref><ref>Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol 2007; 25:188.</ref><ref>Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005; 352:2325.</ref><ref>Doganay M, Aygen B. Human brucellosis: An overview. Int J Infect Dis 2003; 7:173.</ref><ref>Young EJ. Brucellosis: current epidemiology, diagnosis, and management. Curr Clin Top Infect Dis 1995; 15:115.</ref><ref>Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.</ref><ref>Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 2002; 132:98.</ref><ref>Mousa AM, Bahar RH, Araj GF, et al. Neurological complications of brucella spondylitis. Acta Neurol Scand 1990; 81:16.</ref><ref>Pappas G, Bosilkovski M, Akritidis N, et al. Brucellosis and the respiratory system. Clin Infect Dis 2003; 37:e95.</ref><ref>Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.</ref>
{| class="wikitable"
{| class="wikitable"
! colspan="2" |Brucellosis
! colspan="2" |Brucellosis
|-
|-
|Acute brucellosis
|Acute brucellosis
|Patients with Brucellosis, can present with diverse clinical presentation, which include systemic flu-like symptoms and symptoms to local infections:<ref>Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75:195.</ref><ref>Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol 2007; 25:188.</ref><ref>Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005; 352:2325.</ref><ref>Doganay M, Aygen B. Human brucellosis: An overview. Int J Infect Dis 2003; 7:173.</ref><ref>Young EJ. Brucellosis: current epidemiology, diagnosis, and management. Curr Clin Top Infect Dis 1995; 15:115.</ref><ref>Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.</ref><ref>Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 2002; 132:98.</ref><ref>Mousa AM, Bahar RH, Araj GF, et al. Neurological complications of brucella spondylitis. Acta Neurol Scand 1990; 81:16.</ref><ref>Pappas G, Bosilkovski M, Akritidis N, et al. Brucellosis and the respiratory system. Clin Infect Dis 2003; 37:e95.</ref><ref>Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.</ref>
|Systemic symptoms
 
Systemic symptoms
*[[Undulant fever]]
*[[Undulant fever]]
**High fever spikes usually occur every afternoon
**High fever spikes usually occur every afternoon
Line 26: Line 25:


Focal organ wise symptoms:
Focal organ wise symptoms:
* Muscuoskeletal: Joint pain(Commonly in low back and larger joints of lower limbs)
* Muscuoskeletal: [[Joint pain]](Commonly in low back and larger joints of [[lower limbs]])
* Genitourinary: Pain in the genital region and increase in frequency of urination/burning senation while passing urine(2 to 20 percent of cases)
* [[Genitourinary system|Genitourinary]]: Pain in the [[Genital|genital region]] and increase in frequency of [[urination]]/[[Burning during urination|burning senation]] while passing urine(2 to 20 percent of cases)
* Pulmonary: Cough, chest pain, difficulty in breathing(pulmonary involvement present upto 7 percent of patients)
* Pulmonary: [[Cough]], chest pain, difficulty in breathing(pulmonary involvement present upto 7 percent of patients)
* Gastrointestinal: Abdominal pain and symptoms of [[hepatitis]] can be present in 3-6 percent of presenting patients
* Gastrointestinal: [[Abdominal pain]] and symptoms of [[hepatitis]] can be present in 3-6 percent of presenting patients
* Neurological: Headache, confusion or altered sensorium(meningoencephalitits), loss of sensation(radiculopathies or neuritis involving the cranial or peripheral nerves) can be present in 2-7 percent of patients
* Neurological: [[Headache]], [[confusion]] or altered sensorium(meningoencephalitits), [[loss of sensation]](radiculopathies or neuritis involving the [[cranial]] or [[peripheral nerves]]) can be present in 2-7 percent of patients
* Cardiovascular: Chest pain is rare cardiovascular feature of brucellosis
* Cardiovascular: Chest pain is rare cardiovascular feature of brucellosis
* Ocular: Difficulty in vision and Dimenision of vision
* Ocular: Difficulty in [[vision]] and Dimenision of vision
* Dermatology: Rash, ulcer or tender swelling can present with brucellosis upto 10 percent of patient
* Dermatology: Rash, ulcer or tender swelling can present with brucellosis upto 10 percent of patient
|-
|-
|Relapse
|Relapse
|
|
 
[[Relapse]] occurs in 5 to 15 percent of patient usually in first 6 months following treatment, although in rare cases it may even occur in up to 12 months of treatment.<ref>Ariza J, Bosilkovski M, Cascio A, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med 2007; 4:e317.</ref><ref>Ariza J, Corredoira J, Pallares R, et al. Characteristics of and risk factors for relapse of brucellosis in humans. Clin Infect Dis 1995; 20:1241.</ref>
Relapse occurs in 5 to 15 percent of patient usually in first 6 months following treatment, although in rare cases it may even occur in up to 12 months of treatment.<ref>Ariza J, Bosilkovski M, Cascio A, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med 2007; 4:e317.</ref><ref>Ariza J, Corredoira J, Pallares R, et al. Characteristics of and risk factors for relapse of brucellosis in humans. Clin Infect Dis 1995; 20:1241.</ref>
|-
|-
|Chronic Brucellosis
|Chronic Brucellosis
|Presence of clinical manifestation for more then one year after established diagnosis of brucellosis is considered as chronic brucellosis.
|Presence of clinical manifestation for more then one year after established diagnosis of [[brucellosis]] is considered as chronic brucellosis.


Clincial manifestations include:<ref name="pmid7546364">{{cite journal| author=Young EJ| title=Brucellosis: current epidemiology, diagnosis, and management. | journal=Curr Clin Top Infect Dis | year= 1995 | volume= 15 | issue=  | pages= 115-28 | pmid=7546364 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7546364  }}</ref>
Clincial manifestations include:<ref name="pmid7546364">{{cite journal| author=Young EJ| title=Brucellosis: current epidemiology, diagnosis, and management. | journal=Curr Clin Top Infect Dis | year= 1995 | volume= 15 | issue=  | pages= 115-28 | pmid=7546364 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7546364  }}</ref>


Uveitis: patients complains of difficulty of vision
[[Uveitis]]: patients complains of difficulty of vision


Spondylitis, osteomyelitis, Arthralgias: patients complains of pain in joints or joint movement
[[Spondylitis]], [[Osteomyelitis|osteomyelitis,]] [[Arthralgias]]: patients complains of pain in joints or joint movement


Intermittent sweating
Intermittent [[sweating]]
|}
|}


Revision as of 19:10, 9 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] Vishal Devarkonda, M.B.B.S[3]

Overview

Brucellosis can present with diverse clinical presentation, which include systemic flu-like symptoms and symptoms due to focal involvement of organs

Symptoms

Patients with Brucellosis, can present with diverse clinical presentation, which include systemic flu-like symptoms and symptoms due to focal involvement of organs:[1][2][3][4][5][6][7][8][9][10]

Brucellosis
Acute brucellosis Systemic symptoms

Depression

Focal organ wise symptoms:

  • Muscuoskeletal: Joint pain(Commonly in low back and larger joints of lower limbs)
  • Genitourinary: Pain in the genital region and increase in frequency of urination/burning senation while passing urine(2 to 20 percent of cases)
  • Pulmonary: Cough, chest pain, difficulty in breathing(pulmonary involvement present upto 7 percent of patients)
  • Gastrointestinal: Abdominal pain and symptoms of hepatitis can be present in 3-6 percent of presenting patients
  • Neurological: Headache, confusion or altered sensorium(meningoencephalitits), loss of sensation(radiculopathies or neuritis involving the cranial or peripheral nerves) can be present in 2-7 percent of patients
  • Cardiovascular: Chest pain is rare cardiovascular feature of brucellosis
  • Ocular: Difficulty in vision and Dimenision of vision
  • Dermatology: Rash, ulcer or tender swelling can present with brucellosis upto 10 percent of patient
Relapse

Relapse occurs in 5 to 15 percent of patient usually in first 6 months following treatment, although in rare cases it may even occur in up to 12 months of treatment.[11][12]

Chronic Brucellosis Presence of clinical manifestation for more then one year after established diagnosis of brucellosis is considered as chronic brucellosis.

Clincial manifestations include:[13]

Uveitis: patients complains of difficulty of vision

Spondylitis, osteomyelitis, Arthralgias: patients complains of pain in joints or joint movement

Intermittent sweating

References

  1. ↑ Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75:195.
  2. ↑ Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol 2007; 25:188.
  3. ↑ Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005; 352:2325.
  4. ↑ Doganay M, Aygen B. Human brucellosis: An overview. Int J Infect Dis 2003; 7:173.
  5. ↑ Young EJ. Brucellosis: current epidemiology, diagnosis, and management. Curr Clin Top Infect Dis 1995; 15:115.
  6. ↑ Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.
  7. ↑ Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 2002; 132:98.
  8. ↑ Mousa AM, Bahar RH, Araj GF, et al. Neurological complications of brucella spondylitis. Acta Neurol Scand 1990; 81:16.
  9. ↑ Pappas G, Bosilkovski M, Akritidis N, et al. Brucellosis and the respiratory system. Clin Infect Dis 2003; 37:e95.
  10. ↑ Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.
  11. ↑ Ariza J, Bosilkovski M, Cascio A, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med 2007; 4:e317.
  12. ↑ Ariza J, Corredoira J, Pallares R, et al. Characteristics of and risk factors for relapse of brucellosis in humans. Clin Infect Dis 1995; 20:1241.
  13. ↑ Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management". Curr Clin Top Infect Dis. 15: 115–28. PMID 7546364.
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