小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 与受感染个体的接触史
- 发热或寒战
- 全身性症状
- 关节痛
- 关节肿胀和压痛
- 肝大和/或脾大
其他诊断因素
- 恶心、呕吐、腹痛、便秘、腹泻
- 苍白
- 淋巴结肿大
- 干咳
- 胸部征象
- 睾丸痛
- 颈项强直
- 颅神经麻痹或局灶性中枢神经系统功能缺损
- 叩诊浊音、入气量减少、捻发音
- 红眼
- 皮疹
危险因素
- 摄入受污染的食物
- 接触受感染的动物制品
- 吸入受污染的气溶胶
- 与受感染物质的结膜接触
- 可能接触到布鲁氏菌的职业
- 前往疫区旅行
- 皮肤上的切口或擦伤
- 与感染者性接触
- 受感染母亲的新生儿或婴儿
- 血液制品或器官组织移植受体
诊断性检查
首要检查
- 血培养
- 血清学检测
- 脑脊液（CSF）分析
- 脑脊液 (CSF) 培养
- 滑液分析
- 滑液培养
- 全血细胞计数 (FBC）
- 肝功能检查
- 血清电解质
需考虑的检查
- 骨髓培养
- 组织活检
- 受累关节 X 线平片
- 胸部 X 线检查
- 骨扫描
- 脊柱 CT 或 MRI 扫描
- 头部 CT 或 MRI 扫描
新兴检查
- 聚合酶链反应 (PCR) 可用于检测和诊断布鲁氏菌种属
- 基质辅助激光解析电离飞行时间(MALDI-TOF)质谱
治疗流程
非复杂疾病
复杂疾病
撰稿人
作者
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.
鉴别诊断
- 结核病
- 疟疾感染
- 伤寒感染
更多 鉴别诊断指南
- 黄皮书：国际旅行健康信息：布鲁氏菌病
- CDC 黄皮书：国际旅行健康信息：布鲁氏菌病
更多 指南
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