Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- história de contato sexual com pessoa infectada
- febre ou calafrios
- sintomas constitucionais
- artralgia
- inchaço e sensibilidade nas articulações
- hepatomegalia e/ou esplenomegalia
Other diagnostic factors
- náuseas, vômitos, dor abdominal, constipação, diarreia
- palidez
- linfadenopatia
- tosse seca
- sinais torácicos
- dor testicular
- rigidez de nuca
- paralisia do nervo craniano ou deficit focal do sistema nervoso central
- macicez à percussão, expansibilidade diminuída, crepitações
- olho vermelho
- rashes cutâneos
Risk factors
- ingestão de alimentos contaminados
- exposição a produtos animais infectados
- inalação de aerossóis infectados
- contato conjuntival com material infectado
- ocupação com potencial de exposição a espécies de Brucella
- viagem para uma área endêmica
- cortes ou abrasões na pele
- contato sexual com um indivíduo infectado
- neonatos ou lactentes nascidos de mães infectadas
- receptor de transplante de hemoderivados, órgão ou tecido
Diagnostic tests
1st tests to order
- hemocultura
- testes sorológicos
- Análise do líquido cefalorraquidiano (LCR)
- cultura do líquido cefalorraquidiano (LCR)
- análise do líquido sinovial
- cultura do líquido sinovial
- Hemograma completo
- testes da função hepática
- eletrólitos séricos
Tests to consider
- cultura de medula óssea
- biópsia tecidual
- radiografias simples das articulações afetadas
- radiografia torácica
- cintilografia óssea
- tomografia computadorizada (TC) ou ressonância nuclear magnética (RNM) da coluna
- TC ou RNM do crânio
Emerging tests
- reação em cadeia da polimerase (PCR) para detecção e diagnóstico de espécies de Brucella
- espectrometria de massa por tempo de voo com ionização/dessorção a laser assistida por matriz (MALDI-TOF)
Treatment algorithm
doença não complicada
doença complicada
Contributors
Authors
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
Disclosures
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
Disclosures
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
Disclosures
ST declares that she has no competing interests.
Peer reviewers
Mical Paul, MD
Infectious Diseases Consultant
Unit of Infectious Diseases
Rabin Medical Center
Beilinson Hospital
Petah-Tikva
Israel
Disclosures
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
Disclosures
EJY declares that he has no competing interests.
References
Key articles
Pappas G, Papadimitriou P, Akritidis N, et al. The new global map of human brucellosis. Lancet Infect Dis. 2006 Feb;6(2):91-9. Abstract
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.Full text Abstract
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.Full text Abstract
Franco MP, Mulder M, Gilman RH, et al. Human brucellosis. Lancet Infect Dis. 2007 Dec;7(12):775-86. Abstract
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. Abstract
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.Full text Abstract
Yousefi-Nooraie R, Mortaz-Hejri S, Mehrani M, et al. Antibiotics for treating human brucellosis. Cochrane Database Syst Rev. 2012 Oct 17;10:CD007179.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Tuberculose
- Infecção malárica
- Infecção tifoide
More DifferentialsGuidelines
- Yellow Book: health information for international travel: brucellosis
- CDC Yellow Book: health information for international travel: brucellosis
More Guidelines
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