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BrucellosisAka: Brucella abortus, Brucella suis, Brucella melitensis

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  1. Epidemiology
    1. US Incidence <100 cases per year (0.34/100,000)
  2. Etiology
    1. Brucella abortus
    2. Brucella suis
    3. Brucella melitensis
  3. Pathophysiology
    1. Facultative intracellular parasite
      1. Releases endotoxin when dies
    2. Infective dose: 10-100 organisms
    3. Incubation: 5-60 days
  4. Transmission
    1. Infected animal products
      1. Tissue from Sheep in U.S.
      2. Unpasteurized milk
    2. Vaccine exposure
    3. No transmission person to person
    4. Enters via mucus membranes, broken skin, or inhalation
  5. Risk Factors
    1. Veterinarians
    2. Farm workers
    3. Meat processing plants
    4. Travel or residence in endemic region
      1. Mediterranean
      2. India
      3. North Africa, East Africa
      4. Central Asia, South Asia
  6. Symptoms
    1. Intermittent Fevers
      1. Undulating fever
      2. Temperature peaks in evening to 101-104
    2. Arthralgia (90%)
    3. Weakness
    4. Lassitude
    5. Weight loss
    6. Headache
    7. Sweating
    8. Chills
  7. Signs
    1. Hepatosplenomegaly (20-30%)
    2. Cervical or Inguinal Lymphadenopathy (12-20%)
    3. Orchitis or Epididymitis (2-40%)
    4. Purpura (5%)
  8. Differential Diagnosis
    1. Tularemia
    2. Psittacosis
    3. Rickettsia
    4. Visceral Leishmaniasis
    5. Human Immunodeficiency Virus (HIV)
  9. Labs
    1. Culture (Slow growing, fastidious organism)
      1. Blood Culture (70% sensitive in acute illness)
      2. Discharge Culture
      3. Bone Marrow Aspirate (90% sensitive in acute illness)
    2. Complete Blood Count
      1. Thrombocytopenia
      2. Granulopenia
      3. Lymphopenia or Lymphocytosis
      4. Anemia
    3. Brucella Serology
    4. Liver Function Tests (elevated in 30-60%)
    5. Bone Marrow Biopsy show granuloma
  10. Course
    1. Weeks to months
  11. Prognosis
    1. Case Fatality <5% treated
  12. References
    1. (1998) Medical Management of Biological Casualties
      1. U.S. Army Medical Research Institute of ID

Brucella melitensis bacterium (C0006305)

Definition (MSH)A species of the genus BRUCELLA whose natural hosts are sheep and goats. Other mammals, including humans, may be infected. In general, these organisms tend to be more virulent for laboratory animals than BRUCELLA ABORTUS and may cause fatal infections.
ConceptsBacterium (T007)
EnglishBrucella melitensis, Brucella melitensis bacterium, Micrococcus melitensis, Streptococcus Miletensis
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Brucellosis (C0006309)

Definition (MSH)Infection caused by bacteria of the genus BRUCELLA mainly involving the MONONUCLEAR PHAGOCYTE SYSTEM. This condition is characterized by fever, weakness, malaise, and weight loss.
ConceptsDisease or Syndrome (T047)
ICD9023, 023.9
EnglishBrucelloses, Brucellosis, Cyprus fever, Gibraltar fever, Malta Fever, Mediterranean fever, MELITOCOCCOSIS, Rock fever, UNDULANT FEVER, Undulant Fevers
Spanishbrucelosis, fiebre de Malta, fiebre del Mediterráneo, fiebre del Mediterraneo, fiebre mediterránea, fiebre mediterranea, fiebre ondulante
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Brucella suis bacterium (C0300960)

Definition (MSH)A species of gram-negative bacteria, primarily infecting SWINE, but it can also infect humans, DOGS, and HARES.
ConceptsBacterium (T007)
EnglishBrucella melitensis biov suis, Brucella melitensis biovar suis, Brucella melitensis bv. Suis, Brucella suis, Brucella suis bacterium
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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