Brucellosis: Causes and effects #DrRakha
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6 سال پیش
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Brucellosis is a zoonosis and
Brucellosis is a zoonosis and the infection is almost invariably transmitted to people by direct or indirect contact with infected animals or their products. The animal handlers like farmers, veterinarians, butchers and consumers of contaminated animal products are the most vulnerable. The infection persists in domestic animals and, consequently, transmission to the human population frequently occurs. Prompt diagnosis and treatment can greatly help in treatment. In many patients the symptoms are mild and, therefore, the diagnosis may not be even considered. Even in severe infections differential diagnosis can still be difficult.
Brucellosis is essentially a disease of animals, especially domesticated livestock with humans as an accidental host. The human disease usually manifests itself as an acute febrile illness which may persist and progress to a chronically incapacitating disease with severe complications.
Source of infection are infected cattle, sheep, goats and pigs, in which, the infection usually establishes itself in the reproductive tract, often resulting in abortion. Excretion in genital discharges and milk is common and is a major source of human infection. Effective treatment is available for the human disease but prevention is the ideal, through control of the infection in animals and by implementation of hygienic measures.
Brucellosis is an acute or sub-acute febrile illness usually marked by an intermittent or remittent fever accompanied by malaise, anorexia and prostration, and which may persist for weeks or months. Typically, few objective signs are apparent but enlargement of the liver, spleen and/or lymph nodes may occur, as may signs referable to almost any other organ system. The acute phase may progress to a chronic one.
Evidence in support of the diagnosis includes:
• A history of recent exposure to a known or probable source of especially cattle, sheep, goats, pigs, camels, yaks, buffaloes or dogs; consumption of raw or inadequately cooked milk or milk products, and, to a lesser extent, meat and offal derived from these animals.
• Isolation of Brucella spp. from the patient.
• Demonstration by PCR of the presence of Brucella DNA in blood or other tissue sample.
• Demonstration by a validated serological method of Brucella antigen in blood or other tissue sample.
• Demonstration of a rising antibody titre in any serological tests
Common routes of infection include direct inoculation through cuts and abrasions in the skin, inoculation via the conjunctival sac of the eyes, inhalation of infectious aerosols, and ingestion of infectious unpasteurized milk or other dairy products.
The disease is acute in about half the cases, with an incubation period of two to three weeks. In the other half, the onset is insidious, with signs and symptoms developing over a period of weeks to months from the infection.
Clinical manifestations include fever, sweats, fatigue, malaise, anorexia, weight loss, headache, arthralgia and back pain. Commonly, patients feel better in the morning, with symptoms worsening as the day progresses. The desire to rest can be profound, and depression is pervasive. If untreated, the pattern of the fever waxes and wanes over several days (“undulant fever”).
Complications
Bone and joint involvement are the most frequent complications of brucellosis. A variety of syndromes have been reported, including sacroiliitis, spondylitis, peripheral arthritis, osteomyelitis, bursitis, and tenosynovitis. Brucella sacroilitis is especially common. Liver is commonly involved.
Aerosol inhalation is a recognized route of transmission of brucellosis, especially common in abattoirs where infected animals are slaughtered. A variety of pulmonary complications have been reported, including lymphadenopathy, interstitial pneumonitis, bronchopneumonia, lung nodules, pleural effusions, and empyema.
Orchitis and epididymitis are the most frequent genitourinary complications in men. Usually unilateral, Brucella orchitis can mimic testicular cancer or tuberculosis. There have been a few reports implicating sexual transmission.
Brucellosis during the course of pregnancy carries the risk of spontaneous abortion during early trimester or intrauterine transmission to the infant. Abortion is a frequent complication of brucellosis in animals. Very rare human-to-human transmission from lactating mothers to their breastfed infants has been reported.
Infective endocarditis is the most common cardiovascular manifestation, and is the most common cause of death. It often occurs late in the course of disease. Skin lesions like rashes, nodules, papules, erythema nodosum, petechiae, and purpura, cutaneous ulcers, abscesses, and suppurative lymphangitis are common. Uveitis is the most frequent manifestation, Once considered rare in children, it is now recognized that brucellosis can affect persons of all ages.
Brucellosis is essentially a disease of animals, especially domesticated livestock with humans as an accidental host. The human disease usually manifests itself as an acute febrile illness which may persist and progress to a chronically incapacitating disease with severe complications.
Source of infection are infected cattle, sheep, goats and pigs, in which, the infection usually establishes itself in the reproductive tract, often resulting in abortion. Excretion in genital discharges and milk is common and is a major source of human infection. Effective treatment is available for the human disease but prevention is the ideal, through control of the infection in animals and by implementation of hygienic measures.
Brucellosis is an acute or sub-acute febrile illness usually marked by an intermittent or remittent fever accompanied by malaise, anorexia and prostration, and which may persist for weeks or months. Typically, few objective signs are apparent but enlargement of the liver, spleen and/or lymph nodes may occur, as may signs referable to almost any other organ system. The acute phase may progress to a chronic one.
Evidence in support of the diagnosis includes:
• A history of recent exposure to a known or probable source of especially cattle, sheep, goats, pigs, camels, yaks, buffaloes or dogs; consumption of raw or inadequately cooked milk or milk products, and, to a lesser extent, meat and offal derived from these animals.
• Isolation of Brucella spp. from the patient.
• Demonstration by PCR of the presence of Brucella DNA in blood or other tissue sample.
• Demonstration by a validated serological method of Brucella antigen in blood or other tissue sample.
• Demonstration of a rising antibody titre in any serological tests
Common routes of infection include direct inoculation through cuts and abrasions in the skin, inoculation via the conjunctival sac of the eyes, inhalation of infectious aerosols, and ingestion of infectious unpasteurized milk or other dairy products.
The disease is acute in about half the cases, with an incubation period of two to three weeks. In the other half, the onset is insidious, with signs and symptoms developing over a period of weeks to months from the infection.
Clinical manifestations include fever, sweats, fatigue, malaise, anorexia, weight loss, headache, arthralgia and back pain. Commonly, patients feel better in the morning, with symptoms worsening as the day progresses. The desire to rest can be profound, and depression is pervasive. If untreated, the pattern of the fever waxes and wanes over several days (“undulant fever”).
Complications
Bone and joint involvement are the most frequent complications of brucellosis. A variety of syndromes have been reported, including sacroiliitis, spondylitis, peripheral arthritis, osteomyelitis, bursitis, and tenosynovitis. Brucella sacroilitis is especially common. Liver is commonly involved.
Aerosol inhalation is a recognized route of transmission of brucellosis, especially common in abattoirs where infected animals are slaughtered. A variety of pulmonary complications have been reported, including lymphadenopathy, interstitial pneumonitis, bronchopneumonia, lung nodules, pleural effusions, and empyema.
Orchitis and epididymitis are the most frequent genitourinary complications in men. Usually unilateral, Brucella orchitis can mimic testicular cancer or tuberculosis. There have been a few reports implicating sexual transmission.
Brucellosis during the course of pregnancy carries the risk of spontaneous abortion during early trimester or intrauterine transmission to the infant. Abortion is a frequent complication of brucellosis in animals. Very rare human-to-human transmission from lactating mothers to their breastfed infants has been reported.
Infective endocarditis is the most common cardiovascular manifestation, and is the most common cause of death. It often occurs late in the course of disease. Skin lesions like rashes, nodules, papules, erythema nodosum, petechiae, and purpura, cutaneous ulcers, abscesses, and suppurative lymphangitis are common. Uveitis is the most frequent manifestation, Once considered rare in children, it is now recognized that brucellosis can affect persons of all ages.
6 سال پیش
در تاریخ 1397/09/15 منتشر شده
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