Brucellosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Danitza Lukac Vishal Devarkonda, M.B.B.S[2]

Overview

Brucellosis must be differentiated from Typhoid fever, Malaria, Tuberculosis, Lymphoma, Dengue, Leptospirosis, Rheumatic disease, Epstein-barr virus, Toxoplasmosis, Cytomegalovirus, and HIV.

Differentiating Brucellosis from other Diseases

Brucellosis must be differentiated from Typhoid fever, Malaria, Tuberculosis, Lymphoma, Dengue, Leptospirosis, Rheumatic disease, Epstein-barr virus, Toxoplasmosis, Cytomegalovirus, and HIV.

A detailed clinical history which includes recent travel history, recent camping or hunting, consumption of unpasteurized milk or raw meat products, and occupational history should be obtained, in order to differentiate Brucellosis from other diseases.

Differentiating diagnosis of Brucellosis	Symptoms					Signs			Diagnosis		Additional Findings
	Fever	Rash	Diarrhea	Abdominal pain	Weight loss	Painful lymphadenopathy	Hepatosplenomegaly	Arthritis	Lab Findings	Imaging Findings
Brucellosis	✔	✔	✘	✔	✘	✔	✔	✔	Relative lymphocytosis
Typhoid fever	✔	✔	✘	✔	✘	✘	✔	✔	Decreased hemoglobin
Malaria	✔	✘	✔	✔	✘	✘	✔	✔	Microcytosis, Elevated LDH
Tuberculosis	✔	✔	✘	✔	✔	✔	✔	✔	Mild normocytic anemia, hyponatremia, and hypercalcemia
Lymphoma	✔	✘	✘	✔	✔	✘	✔	✘	Increase ESR, Increased LDH
Mumps	✔	✘	✘	✘	✘	✔	✘	✘	Relative lymphocytosis, serum amylase elevated
Rheumatoid arthritis	✘	✔	✘	✘	✘	✘	✘	✔	ESR and CRP elevated , positive rheumatoid factor
SLE	✘	✔	✘	✔	✔	✘	✘	✔	ESR and CRP elevated, positive ANA
HIV	✘	✘	✘	✔	✔	✔	✘	✔