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Brucellosis

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 14 Sep 2025
Última atualização: 29 Jun 2021

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • history of contact with infected person
  • fever or chills
  • constitutional symptoms
  • arthralgia
  • joint swelling and tenderness
  • hepatomegaly and/or splenomegaly
Detalhes completos

Outros fatores diagnósticos

  • nausea, vomiting, abdominal pain, constipation, diarrhea
  • pallor
  • lymphadenopathy
  • dry cough
  • chest signs
  • testicular pain
  • neck stiffness
  • cranial nerve palsy or focal central nervous system deficit
  • dullness to percussion, decreased air entry, crepitations
  • red eye
  • skin rashes
Detalhes completos

Fatores de risco

  • ingestion of contaminated foods
  • exposure to infected animal products
  • inhalation of infected aerosols
  • conjunctival contact with infected material
  • occupation with potential for exposure to Brucella species
  • travel to an endemic area
  • cuts or abrasions in skin
  • sexual contact with infected individual
  • newborn or infant of infected mother
  • recipient of blood products or of organ or tissue transplant
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • blood culture
  • serologic tests
  • cerebrospinal fluid (CSF) analysis
  • cerebrospinal fluid (CSF) culture
  • synovial fluid analysis
  • synovial fluid culture
  • CBC
  • liver function tests
  • serum electrolytes
Detalhes completos

Investigações a serem consideradas

  • bone marrow culture
  • tissue biopsy
  • plain film x-rays of affected joints
  • chest x-ray
  • bone scan
  • CT or MRI scan of spine
  • CT or MRI scan of head
Detalhes completos

Novos exames

  • polymerase chain reaction for detection and diagnosis of Brucella species
  • matrix-assisted laser desorption/ionization time of fligh (MALDI-TOF) mass spectrometry

Algoritmo de tratamento

AGUDA

uncomplicated disease

complicated disease

Colaboradores

Autores

Nicholas J. Beeching, MA, BM BCh, FRCP, FRACP, FFTM RCPS (Glasg), FESCMID, DCH, DTM&H

Consultant and Emeritus Professor of Tropical and Infectious Diseases

Royal Liverpool University Hospital

Liverpool School of Tropical Medicine

Liverpool

UK

利益声明

NJB is partially supported by the National Institute of Health Research Health Protection Unit in Emerging and Zoonotic Infections at the University of Liverpool and Public Health England. Views expressed in this topic are those of the contributor and do not necessarily represent the official position of the National Health Service, the National Institute for Health Research, the Department of Health, or Public Health England. NJB is an author of references cited in this topic.

Alessandro Gerada, MD, MRCP, FRCPath

Consultant in Clinical Microbiology

Liverpool Clinical Laboratories

Royal Liverpool University Hospital

Liverpool

UK

利益声明

AG is an author of several references cited in this topic.

Sherine Thomas, MBChB, MRCP, DTMH

Consultant in Infectious Diseases

Whipps Cross Hospital

London

UK

利益声明

ST declares that she has no competing interests.

同行评议者

Mical Paul, MD

Infectious Diseases Consultant

Unit of Infectious Diseases

Rabin Medical Center

Beilinson Hospital

Petah-Tikva

Israel

利益声明

MP declares that she has no competing interests.

Edward J. Young, MD

Professor of Medicine

Section of Infectious Diseases

Department of Medicine

Baylor College of Medicine

Houston

TX

利益声明

EJY declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Pappas G, Papadimitriou P, Akritidis N, et al. The new global map of human brucellosis. Lancet Infect Dis. 2006 Feb;6(2):91-9. 摘要

Dean AS, Crump L, Greter H, et al. Global burden of human brucellosis: a systematic review of disease frequency. PLoS Negl Trop Dis. 2012;6(10):e1865.全文  摘要

Dean AS, Crump L, Greter H, et al. Clinical manifestations of human brucellosis: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2012;6(12):e1929.全文  摘要

Franco MP, Mulder M, Gilman RH, et al. Human brucellosis. Lancet Infect Dis. 2007 Dec;7(12):775-86. 摘要

Al Dahouk S, Sprague LD, Neubauer H. New developments in the diagnostic procedures for zoonotic brucellosis in humans. Rev Sci Tech. 2013 Apr;32(1):177-88. 摘要

Skalsky K, Yahav D, Bishara J, et al. Treatment of human brucellosis: systematic review and meta-analysis of randomised controlled trials. BMJ. 2008 Mar 29;336(7646):701-4.全文  摘要

Yousefi-Nooraie R, Mortaz-Hejri S, Mehrani M, et al. Antibiotics for treating human brucellosis. Cochrane Database Syst Rev. 2012 Oct 17;10:CD007179.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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