Brucellosis natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
If left untreated, patients with brucellosis may progress to develop focal infections, relapses or a chronic brucellosis.<ref name="f">Brucellosis. CDC. http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/brucellosis. Accessed on February 3, 2016</ref> Common complications of brucellosis 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>
If left untreated, patients with brucellosis may progress to develop focal infections, relapses or a chronic brucellosis.<ref name="f">Brucellosis. CDC. http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/brucellosis. Accessed on February 3, 2016</ref> Common [[Complication (medicine)|complications]] of brucellosis include [[hepatitis|granulomatous hepatitis]], [[arthritis]], [[sacroiliitis]], [[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.<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==
==Natural History==
*Incubation period is 2–4 weeks (range, 5 days to 5 months).  
*[[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.  
*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 a chronic brucellosis.<ref name="f">Brucellosis. CDC. http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/brucellosis. Accessed on February 3, 2016</ref>
*If left untreated, [[patients]] with brucellosis may progress to develop focal [[infections]], [[Relapse|relapses]] or [[Chronic (medicine)|chronic]] brucellosis.<ref name="f">Brucellosis. CDC. http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/brucellosis. Accessed on February 3, 2016</ref>


==Complications==
==Complications==
*Osteoarticular:
*'''Osteoarticular''':
**Bone and joint involvement
**Bone and joint involvement
***Most frequent complications
***Most frequent complications
***The occur in approximately 40% of cases.  
***The occur in approximately 40% of cases.
**Syndromes reported:
****[[Sacroiliitis]]
***Sacroiliitis
*****Most common
****Most common
****[[Bursitis]]
***Bursitis
****Peripheral [[arthritis]]
***Peripheral arthritis
****[[Osteomyelitis]]
***Osteomyelitis
****[[Tenosynovitis]]
***Tenosynovitis  
****[[Spondylitis]]
***Spondylitis


*Cardiovascular:
*'''Cardiovascular''':
**Infective endocarditis
**[[Infective endocarditis]]
***Common cardiovascular complication
***Common cardiovascular complication
***Frequent cause of death
***Frequent cause of death
***It has been reported in approximately 2% of cases
***It has been reported in approximately 2% of cases
***The aortic valve is more commonly affected than the mitral valve
***The [[aortic valve]] is more commonly affected than the [[mitral valve]]
***Valve replacement surgery is usually needed apart from the medical therapy
***[[Valve]] replacement [[surgery]] is usually needed apart from the medical therapy
**Sinus of Valsalva aneurysm
**[[Aneurysm of sinus of valsalva]]
***Common complication when infection is due to B. suis
***Common complication when [[infection]] is due to ''B. suis''


*Hepatobiliary complications:
*'''Hepatobiliary complications:'''
**Granulomatous hepatitis
**[[Granulomatous hepatitis]]
***Due to B. abortus
***Due to ''[[Brucella abortus|B. abortus]]''
**Post-necrotic cirrhosis
**Post-necrotic [[cirrhosis]]
***Very rare
***Very rare
** Chronic suppurative lesions and hepatic abscesses
** Chronic suppurative lesions and [[Hepatic abscess|hepatic abscesses]]
***Due to B. suis
***Due to B. suis


*Genitourinary:
*'''Genitourinary''':
**Orchitis and epididymitis  
**[[Orchitis]] and [[epididymitis]]
***Frequent genioutinary complications within men
***Frequent [[Genitourinary system|genitourinary]] complications within men


*Neurological:
*'''Neurological''':
**Meningitis or meningoencephalitis
**[[Meningitis]] or [[meningoencephalitis]]
***Most common frequent complications of neurobrucellosis
***Most common frequent complications of neurobrucellosis
**Brain and epidural abscesses
**[[Brain abscess|Brain]] and [[epidural abscess]]
**Cerebellar ataxia
**[[Cerebellar ataxia]]
**Cerebral vasculitis
**[[Cerebral vasculitis]]
**Guillain-Barré syndrome
**[[Guillain-Barré syndrome]]
**Haemorrhage
**[[Haemorrhage]]
**Mycotic aneurysms
**[[Mycotic aneurysm]]
**Stroke
**[[Stroke]]
**Neuropathy/radiculopathy
**[[Neuropathy]]/[[radiculopathy]]
**Poliomyelitis-like syndrome
**[[Poliomyelitis]]-like syndrome


*Gastrointestinal:
*'''Gastrointestinal''':
**Colitis,ileitis, and spontaneous bacterial peritonitis.
**[[Colitis]], [[ileitis]], and [[spontaneous bacterial peritonitis]].
***Rare cases have been reported.
***Rare cases have been reported.


*Respiratory tract:
*'''Respiratory tract:'''
**Bronchopneumonia  
**[[Bronchopneumonia]]
**Empyema
**[[Empyema]]
**Hilar and paratracheal lymphadenopathy
**[[Hilar]] and [[Paratracheal lymph nodes|paratracheal lymphadenopathy]]
**Interstitial pneumonitis
**[[Interstitial pneumonitis]]
**Lung nodules
**[[Lung nodule|Lung nodules]]
**Pleural effusions
**[[Pleural effusions]]


* Pregnancy:
* '''Pregnancy''':
**Spontaneous abortion
**[[Spontaneous abortion]]


*Cutaneous:
*'''Cutaneous''':
**Erythema nodosum
**[[Erythema nodosum]]
**Nodules
**[[Nodules]]
**Papules
**[[Papules]]
**Petechiae
**[[Petechiae]]
**Purpura
**[[Purpura]]
**Rashes
**[[Rashes]]
**Abscesses, cutaneous ulcers, and suppurative lymphangitis
**[[Abscesses]], cutaneous ulcers, and [[suppurative]] [[lymphangitis]]
***Common complication when infection is due to B. suis
***Common complication when infection is due to ''B. suis''


*Opthalmic:
*'''Opthalmic''':
**Uveitis
**[[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>
***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==
*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%.  
*The most frequent cause of death was endocarditis.  
*The most frequent cause of death was [[endocarditis]].  
**Recent advances in antibiotics and surgery have been successful in preventing death due to endocarditis.  
**Recent advances in [[antibiotics]] and [[surgery]] have been successful in [[Prevention (medical)|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>
*[[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 15:39, 4 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

If left untreated, patients with brucellosis may progress to develop focal infections, relapses or a chronic brucellosis.[1] Common complications of brucellosis include granulomatous hepatitis, arthritis, sacroiliitis, meningitis, orchitis, epididymitis uveitis, and endocarditis.[2][3] The prognosis of brucellosis is good with treatment. Relapse may occur, and symptoms may continue for years.[2][1]

Natural History

Complications

  • Opthalmic:

Prognosis

Reference

  1. ↑ 1.0 1.1 1.2 1.3 Brucellosis. CDC. http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/brucellosis. Accessed on February 3, 2016
  2. ↑ 2.0 2.1 2.2 Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 3, 2016
  3. ↑ 3.0 3.1 FAO/WHO/OIE Brucellosis in humans and animals. WHO (2006). http://www.who.int/csr/resources/publications/Brucellosis.pdf Accessed on February 3, 2016

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