Brucellosis

Brucellosis is one of the world's most common zoonoses, particularly in poor rural settings. Most cases in northern Europe and North America are acquired overseas and/or from consuming unpasteurized milk or milk products.

Rarely fatal, but relapse can occur with debilitating and economically devastating effects. It is considered a bioterrorism agent, is easily spread by aerosol, and is a significant hazard in microbiology laboratories.

Can affect any organ system and therefore presents in a variety of ways, especially as a prolonged fever of unknown origin, with associated rheumatic features.

Combination antibiotic therapy is the mainstay of treatment and should be used for prolonged periods to prevent relapse of symptoms. There is disagreement about the optimum treatment regimen.

A zoonotic disease that can affect various organs, tissues, and systems.[1]Madkour MM. Madkour's brucellosis. 2nd ed. New York, NY: Springer-Verlag; 2001. In humans it is caused by Brucella species including B melitensis, B abortus, B suis, and B canis (and more rarely by B pinnipediae, B cetaceae, and B inopinata BO1), which are pleomorphic gram-negative bacteria transmitted to humans from animal reservoirs. The disease tends to relapse and can rarely become chronic, although the definition and classification of chronic brucellosis remains controversial.[2]Pappas G, Akritidis N, Bosilkovski M, et al. Brucellosis. N Engl J Med. 2005 Jun 2;352(22):2325-36. http://www.ncbi.nlm.nih.gov/pubmed/15930423?tool=bestpractice.com [3]Hasanjani Roushan MR, Moherez M, Smailnejad Gangi SM, et al. Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran. Epidemiol Infect. 2004 Dec;132(6):1109-14. http://www.ncbi.nlm.nih.gov/pubmed/15635968?tool=bestpractice.com  Brucella species are considered class B bioterrorism agents, due to the ease of infection through the inhalation of organisms. 

BMJ talk medicine podcast: Brucellosis, with Drs Nick Beeching and Alessandro Gerada Opens in new window