ROLE OF BLOOD CULTURES IN DIAGNOSIS OF HUMAN BRUCELLOSIS Overall, blood cultures are positive in 53.4 to 90% of patients with brucellosis but the chances of successful isolation of the organism decrease over time (14, 25).
Brucellosis can be diagnosed in a laboratory by finding bacteria in samples of blood, bone marrow or other bodily fluids. Serological tests can also be done to detect antibodies against the bacteria.
CDC utilizes a test called the Brucella microagglutination test (BMAT), a modified version of the serum (tube) agglutination test (SAT), that can detect antibodies to Brucella species – abortus, melitensis or suis.
Doctors usually confirm a diagnosis of brucellosis by testing blood or bone marrow for the brucella bacteria or by testing blood for antibodies to the bacteria. To help detect complications of brucellosis, your doctor may order additional tests, including: X-rays.
Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases.
Symptoms and Signs of Brucellosis
Onset may be sudden, with chills and fever, severe headache, joint and low back pain, malaise, and occasionally diarrhea. Or onset may be insidious, with mild prodromal malaise, muscle pain, headache, and pain in the back of the neck, followed by a rise in evening temperature.
Brucellosis symptoms may disappear for weeks or months and then return. Some people have chronic brucellosis and experience symptoms for years, even after treatment.
If brucellosis is not treated, the disease may take months to resolve once appropriate therapy is begun. Brucellosis may be confined to a certain area of the body (local) or have serious widespread complications that affect various organ systems of the body including the central nervous system.
The symptoms usually improve and are completely gone within about two to six months. However, the prognosis is poor in people who develop organ changes or complications such as heart damage, neurological, or genitourinary problems caused by chronic Brucella infection.
This method of transmission primarily affects farmers, butchers, hunters, veterinarians and laboratory personnel. Worldwide, Brucella melitensis is the most prevalent species causing human brucellosis, owing in part to difficulties in immunizing free-ranging goats and sheep. Human-to-human transmission is very rare.
Brucellosis is an infectious disease caused by bacteria. People can get the disease when they are in contact with infected animals or animal products contaminated with the bacteria. Animals that are most commonly infected include sheep, cattle, goats, pigs, and dogs, among others.
An abnormal (positive) result usually means you have come in contact with the bacteria that causes brucellosis. However, this positive result does not mean that you have an active infection. Your provider will have you repeat the test after a few weeks to see if the test result increases.
Generally, the antibiotics doxycycline and rifampin are recommended in combination for a minimum of 6-8 weeks.
The advantage of this test is veterinarians can have in-hospital results within two minutes.
In conclusion, brucella antibodies of 1:320 or higher can persist for more than 2 years after successful treatment and clinical cure. Re-evaluation of diagnostic titer of brucellosis is required in brucella-endemic countries.
For simple infections, doxycycline (100 mg PO twice daily for 6 weeks) may be the most appropriate monotherapy; however, relapse rates with such monotherapy approach 40% and as a result, rifampin (600-900 mg/day) is usually added.
Brucellosis can be treated with antibiotics – but it can take a long time, and treatment can be difficult. Depending on the severity of the illness – and when treatment is begun – it can take anywhere from a few weeks to a few months to recover.
Brucellosis (pronounced “bru-cell-OH-sis”) is a disease you get from the bacteria Brucella. It can cause vague symptoms like fever, joint pain and sweating that come and go over a long time. Brucellosis is a zoonotic disease, meaning you get it from animals.
The most common way to be infected is by eating or drinking unpasteurized/raw dairy products. When sheep, goats, cows, or camels are infected, their milk becomes contaminated with the bacteria.
Brucellosis can affect the eye and lead to serious ocular complications. Early diagnosis and prompt treatment should be considered in endemic areas.
The majority of the patients had a positive titre of Brucella melitensis and abortus. In 42% of the patients radiographs of the thoraco-lumbar spine showed bony changes. This study stresses the importance of brucellosis as a cause of backache.
Brucellosis is a reportable condition in all states and territories. Brucellosis cases must be reported to jurisdictions when identified by a healthcare provider, hospital, or laboratory.
The prognosis is generally excellent. Although initial symptoms of brucellosis may be debilitating, if they are treated appropriately and within the first few months of onset, the disease is easily curable, with a low risk of relapse or chronic disease.
It is not found in Australia but occurs in many overseas countries, particularly in the Mediterranean, Middle East, Central Asia and Central America. Brucella abortus usually infects cattle.