Symptoms Of Brucellosis Research Articles

Clinical features and serum profile of inflammatory biomarkers in patients with brucellosis.

Brucellosis is a zoonosis caused by Brucella, a highly infectious Gram-negative coccobacillus that has been isolated from a variety of mammals. Brucella melitensis is considered the most common cause of human brucellosis. The aim of thisretrospectivestudy was to evaluate the diagnostic value of serum parameters that relate to Brucella melitensis infection. This investigation retrospectively analyzed the clinical laboratory tests and symptoms of brucellosis, which was confirmed by microbiological and serological methods. A total of 36 patients (31 males, 5 females; mean age 49.17 ± 13.56 years) admitted with brucellosis were included in the study over a three-year period between 2012 and 2015 in Peking University People's Hospital (PKUPH). A statistically significant increase was observed in C-reactive protein and erythrocyte sedimentation rate in patients with low titers of serum antibody when compared with those with high titers. No difference was observed between the two groups with respect to the other serum parameters such as procalcitonin or white blood cell count. Two blood culture systems also yielded different results. In this study, we demonstrated that culture can be improved by using multiple blood culture systems to isolate Brucella melitensis. We also found the different role of inflammatory markers play during the process of brucellosis. The present study may be a helpful reference in the diagnosis of brucellosis.

A Comparative Evaluation of ELISA, PCR, and Serum Agglutination Tests For Diagnosis of Brucella Using Human Serum

Since the symptoms of Brucellosis are often atypical and nonspecific, using clinical signs alone to diagnose brucellosis is not advised; therefore, the diagnosis relies predominantly on laboratory testing. Currently, molecular, serological, and microbiological methods are used for diagnosis of this disease. In this study we examined ELISA, PCR and serum agglutination (SAT) methods on human patient serum samples. A total of 100 serum samples were collected from suspected patients. Fifty serum samples gave a positive result with the Wright test. The ELISA method was first employed on all samples for the detection of IgG and IgM antibodies against Brucella. Subsequently, the rapid PCR methodology was used to identify presence of Brucella genome in 500 µL of each serum sample. The B4/B5 primer pair was used for PCR‌ amplification. Out of the 100 serum samples obtained from patients with suspected brucellosis, 50 samples tested positive by SAT and displayed high titers of 1/160. Of these 50 positive samples, 49 samples were positive as per the ELISA test whereas one sample tested negative. The PCR test was conducted on all 100 serum samples and results showed that the 45 serum samples that gave a positive agglutination test were also positive by PCR. Various laboratory methods have been used or introduced for the detection of Brucella. Molecular methods such as PCR, a rapid and sensitive method for detection of bacteria, have also been reported. Based on the results of this study, we propose that the simultaneous use of serology and molecular techniques has the potential to overcome limitations of detection thereby enabling the selection of appropriate treatment for the patient.

Seroprevalence of Brucellosis among Patients Attending a District Hospital in Rwanda.

Studies on human brucellosis in Rwanda are scarce, and the incidence is likely to be higher than official estimates. In a recent study using Rose Bengal Test (RBT) on women who had aborted or had still births in Huye district, 25% were Brucella seroprevalent. Thus, purpose of the present study was to investigate the Brucella seroprevalence in patients presenting with the key signs and symptoms of brucellosis. Cross-sectional study was done in Nyagatare District in the Eastern Province of Rwanda. A total of 198 patients were recruited from Nyagatare District Hospital, blood samples were collected, and sera analyzed with RBT. A questionnaire was used to explore the risk factors. A total of 12 patients (6.1%; 95% confidence interval [CI] = 0.662-7.820) were Brucella seropositive. Infection was significantly associated with drinking unboiled milk (odds ratio [OR] = 8.3; 95% CI = 2.4-29.2) and having had recurrent fever (OR = 5.6; 95% CI = 1.5-21.3). Drinking unboiled milk is a risk factor for Brucella infection. Provision of adequate resources and trainings to staff in brucellosis diagnosis is needed to reduce recurrence of fevers probably because of misdiagnosis. Public awareness creation on transmission routes of brucellosis is to be intensified.

Skeletal evidence of brucellosis in a medicolegal context: A report of two cases

Brucellosis is a zoonosis caused by gram-negative bacteria of the genus Brucella. Osteoarticular complications are the most frequent symptoms of brucellosis occurring in up to 40% of the cases. Two brucellosis cases submitted to the Department of Forensic Medicine and Toxicology at the National and Kapodistrian University of Athens Medical School for forensic anthropological evaluation are reported. The value of the contribution of the brucellar lesions to the location of the most likely geographic origin of two missing individuals is presented. The presence of a pathologic condition, such as brucellosis, in skeletal remains can give significant information about the biological profile of an unidentified victim and greatly enhances the chances of obtaining a positive identification.

Latent class evaluation of three serological tests for the diagnosis of human brucellosis in Bangladesh.

BackgroundA Bayesian latent class evaluation was used to estimate the true prevalence of brucellosis in livestock farmers and patients with prolonged pyrexia (PP) and to validate three conditionally dependent serological tests: indirect ELISA (iELISA), Rose Bengal Test (RBT), and standard tube agglutination (STAT). A total of 335 sera from livestock farmers and 300 sera from PP patients were investigated.ResultsThe true prevalence of brucellosis in livestock farmers and PP patients was estimated to be 1.1 % (95 % credibility interval (CrI) 0.1–2.8) and 1.7 % (95 % CrI 0.2–4.1), respectively. Specificities of all tests investigated were higher than 97.8 % (95 % CrI 96.1–99.9). The sensitivities varied from 68.1 % (95 % CrI 54.5–80.7) to 80.6 % (95 % CrI 63.6–93.8). The negative predictive value of all the three tests in both populations was very high and more than 99.5 % (95 % CrI 98.6–99.9). The positive predictive value (PPV) of all three tests varied from 27.9 % (95 % CrI 3.6–62.0) to 36.3 % (95 % CrI 5.6–70.5) in livestock farmers and 39.8 % (95 % CrI 6.0–75.2) to 42.7 % (95 % CrI 6.4–83.2) in patients with PP. The highest PPV were 36.3 % for iELISA and 42.7 % for RBT in livestock farmers and pyrexic patients, respectively.ConclusionsIn such a low prevalence scenario, serology alone does not help in diagnosis and thereby therapeutic decision-making. Applying a second test with high specificity and/or testing patients having history of exposure with known risk factors and/or testing patients having some clinical signs and symptoms of brucellosis may increase the positive predictive value of the serologic tests.Electronic supplementary materialThe online version of this article (doi:10.1186/s41182-016-0031-8) contains supplementary material, which is available to authorized users.

Different Manifestation of Brucellosis in Pregnancy: Case Reports

Brucellosis is a zoonotic disease which is endemic in some areas of Iran. The most common symptoms of brucellosis are fever, nightly sweating, chilling, myalgia, fatigue, back pain and arthralgia. Its misdiagnosis can lead to chronic psy­chological, physical and socioeconomical harms. Mismanagement of infected pregnant women can jeopardize both maternal and fetal safety as well. In this paper we will discuss brucellosis in 5 pregnant women who revealed different manifestations. Surprisingly, none of them had showed fever but it had become apparent after spontaneous abortion. As pregnancy could be accompanied with symptoms like sweating and back pain, the symptoms of brucellosis had been attributed to normal pregnancy and resulted in diagnosis delay. So the unspecific signs and symptoms of involved cases in second or third trimester could not guide the patients or physicians to diagnose brucellosis promptly which resulted in its prolongation, misdiagnosis and mismanagement. J Microbiol Infect Dis 2016;6(2): 80-83

Different Manifestation of Brucellosis in Pregnancy: Case Reports

Brucellosis is a zoonotic disease which is endemic in some areas of Iran. The most common symptoms of brucellosis are fever, nightly sweating, chilling, myalgia, fatigue, back pain and arthralgia. Its misdiagnosis can lead to chronic psychological, physical and socioeconomical harms. Mismanagement of infected pregnant women can jeopardize both maternal and fetal safety as well. In this paper we will discuss brucellosis in 5 pregnant women who revealed different manifestations. Surprisingly, none of them had showed fever but it had become apparent after spontaneous abortion. As pregnancy could be accompanied with symptoms like sweating and back pain, the symptoms of brucellosis had been attributed to normal pregnancy and resulted in diagnosis delay. So the unspecific signs and symptoms of involved cases in second or third trimester could not guide the patients or physicians to diagnose brucellosis promptly which resulted in its prolongation, misdiagnosis and mismanagement. J Microbiol Infect Dis 2016;6(2): 80-83

Seroprevalence and "Knowledge, Attitudes and Practices" (KAPs) survey of endemic ovine brucellosis in Egypt.

BackgroundBetween February and July 2014, a cross-sectional study to estimate the seroprevalence of brucellosis in sheep in the Kafrelsheikh district of Egypt was carried out, together with a survey of knowledge, attitudes and practices (KAPs) among local shepherds. A total of 273 serum samples were collected from 28 sheep flocks in 10 villages within the study area. These samples were analysed by the Rose Bengal Plate test (RBPT) test, with all positive samples being confirmed by complement fixation test (CFT).ResultsTrue seroprevalence was 20 % (95 % CI 15.3–24.7 %) with the prevalence of villages with at least one seropositive sheep estimated at 95.5 % (95 % CI 92.2–100 %); village flock seroprevalence ranged from 0 to 46.8 %. Results of the KAPs survey demonstrated that despite good knowledge regarding brucellosis being potentially present within their flocks, shepherds lacked knowledge regarding routes of livestock to humans disease transmission and the symptoms of brucellosis in humans. This lack of knowledge regarding disease transmission resulted in high-risk practices being widespread—practices such as assisting parturition without protective measures, throwing aborted material into water canals and a reluctance to remove animals that had aborted from the flock.ConclusionsThis study proposes potential measures to reduce seroprevalence of brucellosis in sheep and reduce public health risks from brucellosis such as culling aborted livestock and educational campaigns among shepherds regarding disease risks and modes of transmission.Electronic supplementary materialThe online version of this article (doi:10.1186/s13028-015-0183-2) contains supplementary material, which is available to authorized users.

A long-term survey of brucellosis: Is there any marker to predict the complicated cases?

Background: This study aimed to find markers to predict complicated cases in brucellosis. Patients with and without complications were compared in terms of epidemiological, clinical and laboratory properties. Methods: A total of 700 patients hospitalised at the Department of Infectious Diseases and Clinical Microbiology were evaluated retrospectively. Results: Of a total of 700 patients, 383 (54.7%) were male and mean age was 41.5 ± 17.0 years. Of the patients, 517 (73.8%) were classified as acute cases. Complications occurred significantly less frequently in acute infections (p < 0.001). Increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) occurred more frequently in patients with complicated cases (p = 0.005 and 0.021, respectively), whereas malaise, myalgia and blood culture positivity occurred significantly less frequently in those cases (p <0.001, <0.001 and 0.014, respectively). Fever at examination, loss of malaise and myalgia and blood culture negativity were statistically significant predictive factors for complicated patients in multivariate analysis (p < 0.001, for each). As compared to patients without orchitis, leukocytosis occurred more often in cases with orchitis (p < 0.001); leukopenia occurred more often in neurobrucellosis than in cases without neurobrucellosis (p = 0.008). Of patients who attended control regularly, 422 (98%) were treated successfully. All of the nine patients who did not recover fully were cases with osteoarticular involvement. Conclusions: Fever was the most significant predictive marker of complications. Other classical symptoms of brucellosis like myalgia and malaise were absent in most of the complicated cases. Blood culture was of limited value in the diagnosis of complicated cases most of the time.

Gum and Nose Bleeding as a Presentation of Pediatric Brucellosis

Introduction: Brucellosis symptoms are nonspecific; the most common complaints include fever, sweats, anorexia, headache, malaise, and arthralgia. Hematological manifestations of active brucellosis vary from mild anemia and leukopenia to thrombocytopenia and rarely pancytopenia. Case Presentation: We report on an eight-year-old boy who presented epistaxis and gum bleeding. The physical examination revealed petechiae, purpura, ecchymosis, and cervical while inguinal lymphadenopathy and splenomegaly were noted. Brucella agglutinin titer was positive. After five days of specific therapy for brucellosis, fever was controlled, clinical signs and symptoms were improved and platelet count was dramatically increased. Conclusions: Sever thrombocytopenia and bleeding may be the presentation of brucellosis.

Vertebral Osteomyelitis and Paraspinal Abscess Among Patients With Brucellosis

Background: Brucellosis is a systemic bacterial disease transmitted from animals to humans and involves many organs and tissues. Symptoms of brucellosis are protean and can be similar to many other infectious diseases. None of the symptoms are specific enough to support the clinical diagnosis. The musculoskeletal system is one of the most commonly affected organs. Disease can be present with bursitis, sacroiliitis, peripheral arthritis, osteomyelitis, spondylitis and paraspinal abscess, which among them vertebral osteomyelitis and paraspinal abscess are rare. Objectives: In this study, we aimed to evaluate the prevalence of vertebral osteomyelitis and paraspinal abscess in patients with brucellosis who were admitted to an infectious hospital in Zahedan, Southeastern Iran. Patients and Methods: During 48 months, from December 2008 to October 2012 we evaluated all patients who were referred to infectious clinics (Zahedan, Southeastern Iran) because of fever, myalgia, arthralgia, chronic low back pain, bone pain and had a wright positive test. Blood samples were tested again for 2ME. A titer of more than 1/80 was positive. All patients with low back pain who had a MRI or spine CT-Scan, which showed a sign of osteomyelitis and/or cold abscess, were included in our study. Results: Among 73 patients with brucellosis (56 males, 17 females; age range 12-69 years), 14 patients (19%; 12 males) had a diagnosis of brucella osteomyelitis. Eleven patients had vertebral osteomyelitis and five showed an abscess next to the involved spine. Patients were treated with a triple regimen including: doxicycline, rifampin and streptomycin, and one patient needed surgery due to pressure effect on the spine. Conclusions: Localized complications of brucellosis such as bone involvement were observed in patients with acute disease or chronic untreated infection. Based on our results, in endemic areas, every patient with low back pain and a positive test for brucella should be evaluated for spinal osteomyelitis.

Evaluation of Simple and Rapid Specific IgM/IgG Flow Assay and Some Methods Used in Diagnosis of Brucellosis in Gezira and Blue Nile States, Sudan

Brucellosis is a multisystem disease which may present with broad spectrum clinical manifestations which often nonspecific. In Sudan it is one of the febrile illnesses affecting human welfare. In this study, blood samples were collected from 120 individuals who had clinical symptoms of Brucellosis from Gezira and Blue Nile states in Sudan, and 60 apparently healthy individuals as a control. For diagnosis we evaluated the blood culture and three serological tests, Rose Bengal Test (RBT), Serum Agglutination Test (SAT) and the spcific IgM and IgG immuno flow assay test. The results obtained revealed that, 12/120 (10%), 7/120 (6.8%) and 6/120(5.0%) were positive for Brucellosis by RBT, SAT and IgM and IgG flow assay test respectively and no correlation between the three tests, while the blood culture was done for 81/120(67.5%) of the cases, none yielded positive for brucella. This study concluded that the serological methods were superior to bacteriological method for diagnosing Brucellosis, especially IgM and IgG flow assay test and SAT.

Knowledge and perceptions of brucellosis in the pastoral communities adjacent to Lake Mburo National Park, Uganda

BackgroundBrucellosis is one of the most common zoonotic infections globally. Lack of knowledge about brucellosis may affect the health-seeking behavior of patients, thus leading to sustained transmission in these communities. Our study assessed knowledge and perceptions of brucellosis among pastoral communities adjacent to Lake Mburo National Park (LMNP), Kiruhura District, Uganda.MethodsA community cross-sectional questionnaire survey involving 371 randomly selected household heads from three sub-counties neighboring LMNP were interviewed between June and August 2012. Data collected included communities’ knowledge on causes, symptoms, transmission, treatment, prevention and risk factors of brucellosis. Multivariable logistic regression analysis was performed to explore strength of association between overall knowledge of brucellosis and various individual factors using odds ratios and 95% confidence intervals.ResultsOnly 70 (19%) knew the symptoms of brucellosis in animals, and three quarters (279, 75.5%) mentioned joint and muscle pain as a common symptom in humans. Almost all participants (370, 99.3%) had ever heard about brucellosis, majority (311, 84.7%) believed it affects all sexes and two thirds (67.7%) of the respondents believed close proximity to wildlife contributes to the presence of the disease. Almost all (352, 95.4%) knew that brucellosis in humans could be treatable using modern drugs. The main routes of infection in humans such as consumption of unpasteurized dairy products were known by 97% (360/371); eating of half-cooked meat by 91.4% and eating contaminated pasture in animals by 97.4%. There was moderate overall knowledge of brucellosis 197 (53.1%). Factors associated with higher overall knowledge were being agro-pastoralists (aOR: 2.08, CI: 1.17-3.71) compared to pure pastoralists while those who reported that the disease was a health problem (aOR: 0.18, CI: 0.06-0.56) compared to those who said it was not were less likely to be knowledgeable.ConclusionsThere was moderate overall knowledge of human and animal brucellosis among the participants. Majority of the participants believed that close proximity to wildlife contributes to the presence of the disease in the area. There is a need for collaboration between the public health, veterinary and wildlife sectors to provide health education on brucellosis for better management of the disease in the communities.

Perencanaan Surveilans Brucellosis pada Manusia di Jawa Barat dengan Menggunakan Metode Geographical Information System (GIS)

Brucellosis is a zoonotic disease transmitted from animals and humans. The main source of brucellosis are ruminant animals such as dairy cows and sheep. Symptoms of human brucellosisis acute and non-specific that the reporting of cases are very rare. GIS-based surveillance is needed to detect Brucellosis disease patterns so that it can be made effective prevention programs, it aims to achieve optimal public health. The study was a reviewer from literature in Google and Pubmed by searching keywords are human Brucellosis, surveilance of human brucellosis and geographical information system (GIS). Based on the results of the literature searching, the use of GIS methods in human Brucellosis surveillance is still rare due to the low number of recording cases of Brucellosis in humans.Publics are also not know that brucellosis is zoonotic disease, further more clinical symptoms of brucellosis is acute and not specific.Surveillance of Brucellosis using GIS methods is necessary to ensure the prevention of brucellosis in animals and humans can be performed effectively in order to reach animal and human health systems are optimal. Key words : Human brucellosis, Surveillance, GIS

Study of the Assimilation Rate of Immunoenzymatic Tests and Traditional Serological Methods in the Diagnosis of Human Brucellosis

Background: Brucellosis is a disease carried by animals that can be transmitted to humans. The signs and symptoms of brucellosis are nonspecific, blood tests and blood/tissue cultures are necessary for making the diagnosis of brucellosis. Testing for antibodies against the bacteria and isolating the organism from blood cultures and biopsy of body tissue (from the bone marrow or the liver) are various methods of diagnosis of brucellosis. In the absence of bacteriologic confirmation, a presumptive diagnosis can be made on the basis of high or rising titers of specific antibodies. Objectives: It is observed practically, that the sensitivity of serological tests is less than the amounts mentioned in the reference books. Elisa is a new method for diagnosis of the disease and in this study; application and its assimilation rate are compared with traditional serological tests. Materials and Methods: In this study, patients were selected who had suspicious clinical symptoms of brucellosis. Serological and Elisa tests were performed simultaneously. Results: In this setting, detection rate of the disease is 34.86%, if the high normal titer for the Wrights test titer assumed 1/80 and is 44.95% if the titer assumed 1/40, while Elisa test had detection rate of 58.72% for those suspicious cases. Furthermore, the detection rate for diagnosis of active brucellosis with 2ME tests was 17.54% with high normal titer of 1/80 and was 59.64% with a high normal titer of 1/40. Conclusions: The use of the Elisa tests is preferable for the diagnosis, and if the serological tests are used it is better that the high normal titer assumed to be 1/40.

Epidemiological and Clinical Aspects of Human Brucellosis in Eastern Anatolia

We investigated the seroprevalence of human brucellosis and risk factors in a village in Eastern Anatolia, Turkey, where a brucellosis outbreak among cattle had recently occurred. All 501 inhabitants enrolled were screened with the Rose Bengal Test and were asked to fill out a questionnaire to determine the signs and symptoms of brucellosis and the risk factors. Patients' laboratory findings and clinical responses were also evaluated. The Rose Bengal Test was positive in 44 persons. In comparison of age groups, fever (20.2%), arthralgia (19.2%) and weight loss (8.4%) were frequently seen in children (p<0.05). Hepatomegaly (17.9%) was also prevalent in the age group of 0 to 14 years (p<0.05). The consumption of dairy products, a family history of brucellosis, and raising livestock were significantly related to seropositivity (p<0.05). Rifampicin plus doxycyline was the most common regimen administered in these cases (54.5%) and also had the highest relapse rate (p<0.05). Brucellosis remains an important public-health problem in the rural areas of Turkey. Appropriate public health measures and education must be pursued to eradicate human brucellosis.

A Serological Diagnostic Survey for &lt;i&gt;Brucella canis&lt;/i&gt; Infection in Turkish Patients with Brucellosis-Like Symptoms

The incidence of Brucella canis infection in humans is unknown in Turkey. In this study, we investigated the prevalence of B. canis infection in human sera obtained from six regions in Turkey and comparatively evaluated the results obtained by agglutination-based techniques using standardized antigens made from B. canis. The patients (n = 1,746) presented with clinical symptoms that were similar to those of brucellosis. All patients who tested negative in the Rose Bengal test for the smooth Brucella strains (abortus, melitensis, and suis) were screened for evidence of B. canis infection using the rapid slide agglutination test (RSAT), the microagglutination test (MAT), and the 2-mercaptoethanol RSAT test (2ME-RSAT). Of the samples tested, 157 (8.9%), 68 (3.8%), and 66 (3.7%) were positive for B. canis, as determined by RSAT, MAT, and 2ME-RSAT, respectively. The diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of RSAT were 100%, 94.6%, 42%, and 100%, respectively, and of MAT were 100%, 99.9%, 97%, and 100%, respectively. We recommend the routine use of MAT and 2ME-RSAT to check the sera of all patients with symptoms of brucellosis who are negative for brucellosis using a smooth Brucella antigen.

A Case of Neurobrucellosis Presenting With Isolated Intracranial Hypertension

Despite being a treatable and preventable zoonosis, brucellosis is still endemic in certain areas of the world. Nervous system involvement is a rare but an important complication of brucellosis in childhood. Neurobrucellosis should be taken into consideration in the differential diagnosis of any kind of neurological signs, particularly in endemic areas. The authors present a patient with neurobrucellosis who presented with isolated intracranial hypertension without any other systemic symptoms of brucellosis.

The Rose Bengal Test in Human Brucellosis: A Neglected Test for the Diagnosis of a Neglected Disease

Brucellosis is a highly contagious zoonosis affecting livestock and human beings. The human disease lacks pathognomonic symptoms and laboratory tests are essential for its diagnosis. However, most tests are difficult to implement in the areas and countries were brucellosis is endemic. Here, we compared the simple and cheap Rose Bengal Test (RBT) with serum agglutination, Coombs, competitive ELISA, Brucellacapt, lateral flow immunochromatography for IgM and IgG detection and immunoprecipitation with Brucella proteins. We tested 208 sera from patients with brucellosis proved by bacteriological isolation, 20 contacts with no brucellosis, and 1559 sera of persons with no recent contact or brucellosis symptoms. RBT was highly sensitive in acute and long evolution brucellosis cases and this related to its ability to detect IgM, IgG and IgA, to the absence of prozones, and to the agglutinating activity of blocking IgA at the pH of the test. RBT was also highly specific in the sera of persons with no contact with Brucella. No test in this study outperformed RBT, and none was fully satisfactory in distinguishing contacts from infected patients. When modified to test serum dilutions, a diagnostic titer >4 in RBT resulted in 87.4% sensitivity (infected patients) and 100% specificity (contacts). We discuss the limitations of serological tests in the diagnosis of human brucellosis, particularly in the more chronic forms, and conclude that simplicity and affordability of RBT make it close to the ideal test for small and understaffed hospitals and laboratories.

Infliximab and brucellosis: not the usual suspects, this time

Tumor necrosis factor (TNF) plays an important role in the host defense mechanism, and anti-TNF antibody therapies may increase the risk of serious infections. We herein report a case of 57-year-old male with rheumatoid arthritis who developed brucellosis during treatment with infliximab in combination with methotrexate and a low-dose steroid. Brucellosis should be kept in mind, particularly in endemic areas, in patients receiving anti-TNF therapy. Clinicians should be aware of brucellosis symptoms and ways of contamination and should warn their patients. Early diagnosis and rapid treatment may prevent a possible poor course of the disease in immunocompromised patients.