Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presencia de factores de riesgo
- antecedentes de contacto con personas infectadas
- fiebre o escalofríos moderados
- síntomas constitucionales
- artralgia
- inflamación y sensibilidad de la articulación a la palpación
- hepatomegalia y/o esplenomegalia
Outros fatores diagnósticos
- náuseas, vómitos, dolor abdominal, estreñimiento, diarrea
- palidez
- linfadenopatía
- tos seca
- signos en el tórax
- dolor testicular
- rigidez de nuca
- parálisis del nervio craneal o déficit focal del sistema nervioso central
- matidez a la percusión, disminución de la entrada de aire, crepitaciones
- ojo rojo
- erupciones cutáneas
Fatores de risco
- ingesta de alimentos contaminados
- exposición a productos infectados de origen animal
- inhalación de aerosoles infectados
- contacto conjuntival con material infectado
- ocupación con potencial de exposición a las especies de Brucella
- viajar a una zona endémica
- cortes o abrasiones en la piel
- contacto sexual con un individuo infectado
- recién nacido o lactante de madre infectada
- receptor de hemoderivados o de un trasplante de órgano o tejido
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- hemocultivo
- pruebas serológicas
- análisis de líquido cefalorraquídeo (LCR)
- cultivo de líquido cefalorraquídeo (LCR)
- análisis del líquido sinovial
- cultivo del líquido sinovial
- hemograma completo (HC)
- pruebas de función hepática
- electrolitos séricos
Investigações a serem consideradas
- cultivo de médula ósea
- biopsia de tejido
- radiografías simples de las articulaciones afectadas
- radiografía de tórax
- gammagrafía ósea
- exploración por tomografía computarizada (TC) o resonancia magnética (IRM) de la columna
- exploración por tomografía computarizada (TC) o resonancia magnética (IRM) de la cabeza
Novos exames
- reacción en cadena de la polimerasa (PCR) para la detección y diagnóstico de especies de Brucella
- espectrometría de masas desorción/ionización por láser asistida por matriz con analizador de tiempo de vuelo (MALDI-TOF MS)
Algoritmo de tratamento
enfermedad no complicada
enfermedad complicada
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
Declarações
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 the UK Health Security Agency. 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 the UK Health Security Agency. 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
Declarações
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
Declarações
ST declares that she has no competing interests.
Revisores
Mical Paul, MD
Infectious Diseases Consultant
Unit of Infectious Diseases
Rabin Medical Center
Beilinson Hospital
Petah-Tikva
Israel
Declarações
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
关键文献
Centers for Disease Control and Prevention. Brucellosis reference guide: exposures, testing and prevention. Feb 2017 [internet publication].全文
World Health Organization. Brucellosis in humans and animals. 2006 [internet publication].全文
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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