Abstract
The use of enzyme-linked immunosorbent assay (ELISA) for the detection of IgG and IgM antibodies antibrucella has become widespread in the diagnosis of human brucellosis. IgM anti-Brucella antibodies are indicative of acute infection. Between 2009–2013, 5307 patients were evaluated for serologic diagnosis at the Microbiology Laboratory of the Albacete General Hospital. A ELISA IgM-positive, IgG-negative anti-Brucella antibody serology pattern was detected in 17 of those patients. Epidemiology data, symptoms, laboratory data, treatment and outcome from these patients were reviewed. Sixteen patients presented with musculoskeletal pain, fatigue and/or fever and 1 was asymptomatic. Five patients received treatment with doxycycline combined with rifampin, gentamycin or streptomycin during 6–12 weeks, with no improvement. None of the 17 patients were finally diagnosed with brucellosis. Our results indicate that anti-Brucella IgM positive serology, per se, is not enough to diagnose acute brucellosis and other methods should be used for confirmation. Brucella serology data should be interpreted taking into account the patient's clinical history and epidemiological context.
Highlights
Human brucellosis is a zoonosis with a worldwide distribution, with a low incidence in developed countries, but great importance in developing countries
From April 2009 to February 2013, enzyme-linked immunosorbent assay (ELISA) serology was performed on 5307 patients, with a total of 6175 samples processed
5703 samples were negative for both IgG and IgM, 10 samples were positive for both IgG and IgM, 394 samples were positive for IgG and negative for IgM, and 68 samples were negative for IgG and positive or uncertain for IgM detection. These latter 68 samples were from 26 patients. One of these patients had acute brucellosis with one determination that was positive for IgM and negative for IgG, but subsequent determinations were positive for both IgM and IgG
Summary
Human brucellosis is a zoonosis with a worldwide distribution, with a low incidence in developed countries, but great importance in developing countries. Despite the efforts made to achieve its control or eradication, brucellosis remains prevalent in many countries of the Mediterranean area, the Middle East, lndia, Central Asia and Central and South America [1]. The disease may present with a wide variety of symptoms and signs They include fever, chills, arthralgia, fatigue or lumbar pain. Similar symptoms may be caused by other infectious diseases such as Q fever, Salmonella infections, tuberculosis or viral infections, and even non-infectious diseases [2]. For this reason adequate laboratory diagnostic methods to confirm the clinical suspicion become necessary
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