Brucellosis

Abstract

Isolation of Brucella from clinical specimens is irrefutable evidence of an infection; however, due to the nature of the disease, the diagnosis is usually dependent on serological results. Although refined serological methods have been developed, the standard tube-agglutination test is still the method of choice for serological diagnosis of acute brucellosis. Demonstration of a rising antibody titer during the course of illness is sufficient to allow the physician to diagnose brucellosis, with some confidence, in a patient with a history of animal contact and a clinical illness characterized by fever, sweats, fatigue, and joint and limb pains. The difficulty arises when attempting to diagnose subacute or chronic brucellosis in a patient with continued exposure to Brucella organisms, such as a veterinarian or abbatoir worker. These patients, because of the occupational exposure, frequently have high antibody titers. Thus, positive serological results must be carefully and critically assessed along with clinical and epidemiological findings before the diagnosis is made.