Brucellosis natural history, complications and prognosis: Difference between revisions
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==Overview== | |||
The disease's [[wiktionary:sequela|sequelae]] are highly variable and may include [[hepatitis|granulomatous hepatitis]], [[arthritis]], sacroilitis, [[meningitis]], orchitis, epididymitis [[uveitis]], and [[endocarditis]].<ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 3, 2016</ref><ref name="abc">FAO/WHO/OIE Brucellosis in humans and animals. WHO (2006). http://www.who.int/csr/resources/publications/Brucellosis.pdf Accessed on February 3, 2016 </ref> The prognosis of brucellosis is good with treatment. Relapse may occur, and symptoms may continue for years. As with tuberculosis, the illness can come back after a long period of time.<ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 1, 2016</ref><ref name="f">Brucellosis. Medline Plus. https://www.nlm.nih.gov/medlineplus/ency/article/000597.htm. Accessed on February 3, 2016</ref> | |||
== | ==Natural History== | ||
==Complications== | ==Complications== | ||
* Bone and joint | *Osteoarticular: | ||
* | **Bone and joint involvement | ||
* | ***Most frequent complications | ||
* | ***The occur in approximately 40% of cases. | ||
**Syndromes reported: | |||
***Sacroiliitis | |||
****Most common | |||
***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 | |||
**Sinus of Valsalva aneurysm | |||
***Common complication when infection is due to B. suis | |||
*Hepatobiliary complications: | |||
**Granulomatous hepatitis | |||
***Due to B. abortus | |||
**Post-necrotic cirrhosis | |||
***Very rare | |||
** Chronic suppurative lesions and hepatic abscesses | |||
***Due to B. suis | |||
*Genitourinary: | |||
**Orchitis and epididymitis | |||
***Frequent genioutinary complications within men | |||
*Neurological: | |||
**Meningitis or meningoencephalitis | |||
***Most common frequent complications of neurobrucellosis | |||
**Brain and epidural abscesses | |||
**Cerebellar ataxia | |||
**Cerebral vasculitis | |||
**Guillain-Barré syndrome | |||
**Haemorrhage | |||
**Mycotic aneurysms | |||
**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 lymphadenopathy | |||
**Interstitial pneumonitis | |||
**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">FAO/WHO/OIE Brucellosis in humans and animals. WHO (2006). http://www.who.int/csr/resources/publications/Brucellosis.pdf Accessed on February 3, 2016 </ref> | |||
==Prognosis== | ==Prognosis== | ||
Relapse may occur, and symptoms may continue for years. As with tuberculosis, the illness can come back after a long period of time. | *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. As with tuberculosis, the illness can come back after a long period of time.<ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 1, 2016</ref><ref name="f">Brucellosis. Medline Plus. https://www.nlm.nih.gov/medlineplus/ency/article/000597.htm. Accessed on February 3, 2016</ref> | |||
==Reference== | ==Reference== |
Revision as of 16:00, 3 February 2016
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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
The disease's sequelae are highly variable and may include granulomatous hepatitis, arthritis, sacroilitis, meningitis, orchitis, epididymitis uveitis, and endocarditis.[1][2] The prognosis of brucellosis is good with treatment. Relapse may occur, and symptoms may continue for years. As with tuberculosis, the illness can come back after a long period of time.[1][3]
Natural History
Complications
- Osteoarticular:
- Bone and joint involvement
- Most frequent complications
- The occur in approximately 40% of cases.
- Syndromes reported:
- Sacroiliitis
- Most common
- Bursitis
- Peripheral arthritis
- Osteomyelitis
- Tenosynovitis
- Spondylitis
- Sacroiliitis
- Bone and joint involvement
- 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
- Sinus of Valsalva aneurysm
- Common complication when infection is due to B. suis
- Infective endocarditis
- Hepatobiliary complications:
- Granulomatous hepatitis
- Due to B. abortus
- Post-necrotic cirrhosis
- Very rare
- Chronic suppurative lesions and hepatic abscesses
- Due to B. suis
- Granulomatous hepatitis
- Genitourinary:
- Orchitis and epididymitis
- Frequent genioutinary complications within men
- Orchitis and epididymitis
- Neurological:
- Meningitis or meningoencephalitis
- Most common frequent complications of neurobrucellosis
- Brain and epidural abscesses
- Cerebellar ataxia
- Cerebral vasculitis
- Guillain-Barré syndrome
- Haemorrhage
- Mycotic aneurysms
- Stroke
- Neuropathy/radiculopathy
- Poliomyelitis-like syndrome
- Meningitis or meningoencephalitis
- Gastrointestinal:
- Colitis,ileitis, and spontaneous bacterial peritonitis.
- Rare cases have been reported.
- Colitis,ileitis, and spontaneous bacterial peritonitis.
- Respiratory tract:
- Bronchopneumonia
- Empyema
- Hilar and paratracheal lymphadenopathy
- Interstitial pneumonitis
- 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[2]
- 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. As with tuberculosis, the illness can come back after a long period of time.[1][3]
Reference
- ↑ 1.0 1.1 1.2 Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/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. Medline Plus. https://www.nlm.nih.gov/medlineplus/ency/article/000597.htm. Accessed on February 3, 2016