| Disease/Syndrome |
Brucellosis |
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| Category |
Infection, Occupational |
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| Acute/Chronic |
Acute-Moderate |
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| Synonyms |
Undulant fever; Malta fever; Mediterranean fever; Brucella abortus infection; B. mellitensis infection; B. suis infection; B. canis infection |
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| Biomedical References |
Search PubMed |
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| Comments |
FINDINGS: Patients recover in 2-3 weeks in uncomplicated cases. The three forms are acute (<8 weeks), undulant (<1 year), and chronic (>1 year). Arthralgias are common in all forms. Both infectious and reactive arthritides occur. Bone involvement is also common. About 3% to 15% of patients have spondylitis, usually of the lumbar spine. Less than 1/3 of patients have lymphadenopathy and hepatosplenomegaly. Abnormal liver function tests are common in acute and undulant brucellosis. Gastrointestinal symptoms occur in up to 70% of patients. Jaundice is rare. Anemia, leukopenia, and thrombocytopenia are common in the undulant form. Patients in endemic areas may have constipation. Travelers are more likely to present with diarrhea. The chronic form affects mainly older individuals and includes depression, eye disease, and CNS infections. About 10% of infected men develop epididymitis and/or orchitis. Endocarditis, usually involving the aortic valve, has been reported as one of the common causes of death in patients with brucellosis. Brucella is a common cause of uveitis in endemic areas. Neurobrucellosis (meningitis, encephalitis, myelitis, radiculitis, and neuritis) affects approximately 2% to 5% of patients. [ID, p. 164, 1362, 1717-20; Guerrant, p. 463-5; Merck Manual, p. 1091, 1458; 5MCC;] EPIDEMIOLOGY: Brucellosis is a generalized bacterial infection characterized by irregular fever (undulant fever). It is an occupational disease for workers who handle infected animals and their tissues. Affected workers include farmers, hunters, veterinarians, butchers, and slaughterers. Airborne transmission occurs in animal stables and pens, slaughterhouses, and medical laboratories. A vaccine to prevent the disease in animals is available. Infections have been reported in cattle, swine, goats, sheep, dogs, coyotes, bison, elk, caribou, and deer. Transmission by raw milk and cheese and by contaminated meat has been reported. Brucellosis is endemic in Peru, Mexico, Spain, Greece, Iraq, Iran, Jordan, and Kuwait. [CCDM, p. 75-8; Foodborne Illnesses. CDC. 4/16/04; ID, p. 1717] |
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| Latency/Incubation |
5 days to 8 weeks; usually 1-2 months |
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| Diagnostic |
Culture; Paired sera; Combine agglutinating and non-agglutinating antibody tests; [CCDM, p. 75] Supportive evidence = agglutination titer >1:100; [Current Consult, p. 200] Detection of IgM by easy and accurate dipstick now available; [5MCC] |
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| ICD-9 Code |
023 |
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| Effective Antimicrobics |
Yes |
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| Scope |
Global; Primarily an occupational disease, especially in Mediterranean countries, Middle East, Africa, central Asia, central and S. America, India, and Mexico; [CCDM] |
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| Reference Link |
CDC - Brucellosis |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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