Brucella spp are gram-negative, non-motile, oxidase-positive, urease-negative, coccobacilli. Brucella species are the cause of a zoonosis: brucellosis. A remarkable feature is its sensitivity to blue light (Science).
Brucellosis is primarily an occupational disease contracted from animals by aerosol, direct contact with the infected animal or by consumption of unpasteurized milk. Other occupational hazards occur in slaughterhouse workers, and laboratory workers who may encounter brucella spp in culture.
Symptoms
Symptoms of brucellosis are typically a triad of undulant fevers, sweating and migratory arthralgia. Laboratory abnormalities may include elevated ASAT, ALAT , leukopenia and anemia. Chronic brucellosis may become focal, typically sacroiliitis, arthritis, spondylodiscitis or orchitis (in men).
Diagnosis
Brucella infection is preferably diagnosed by culturing the organism from blood or bone marrow. Positive serology is suggestive of disease but negative results do not exclude the diagnosis.
Treatment
Treatment of brucellosis is effective with 4 weeks of doxycyclin + 2 weeks of streptomycin. Gentamycin for 7 days instead of streptomycin may be equally effective (pubmed, CID).
SWAB advises 6 weeks of doxycyclin combined with 2 weeks of streptomycin or 7 days of gentamycin.
Alternative regimens: doxycyclin + rifampicin both for 6 weeks OR cotrimoxazole for 6 weeks + rifampicin for 2 weeks.
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