Brucellosis diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Danitza Lukac

Overview

The diagnosis of brucellosis is based on clinical and laboratory criteria.

Diagnostic Criteria

• Clinical Description
  • An illness characterized by acute or insidious onset of fever and one or more of the following:
    • Night sweats
    • Arthralgia
    • Headache
    • Fatigue
    • Anorexia
    • Myalgia
    • Weight loss
    • Arthritis/spondylitis
    • Meningitis
    • Focal organ involvement (endocarditis, orchitis/epididymitis, hepatomegaly, splenomegaly)
• Laboratory Criteria for Diagnosis
  • Definitive:
    • Culture and identification of Brucella spp. from clinical specimens
    • Evidence of a fourfold or greater rise in Brucella antibody titer between acute- and convalescent-phase serum specimens obtained greater than or equal to 2 weeks apart
  • Presumptive:
    • Brucella total antibody titer of greater than or equal to 160 by standard tube agglutination test (SAT) or Brucella microagglutination test (BMAT) in one or more serum specimens obtained after onset of symptoms
    • Detection of Brucella DNA in a clinical specimen by PCR assay

Case Classification

• Probable
  • A clinically compatible illness with at least one of the following:
    • Epidemiologically linked to a confirmed human or animal brucellosis case
    • Presumptive laboratory evidence, but without definitive laboratory evidence, of Brucella infection
• Confirmed
  • A clinically compatible illness with definitive laboratory evidence of Brucella infection