Brucellosis

Signs and Symptoms

Look for fever, headache, muscle pain, joint pain, back pain, sweats, chills, and generalized malaise. Also depression, mental status changes. Fatalities are uncommon.

Diagnosis

Diagnosis requires a high index of suspicion, since many infections present as non-specific febrile illnesses or are asymptomatic. Laboratory diagnosis can be made by blood culture with prolonged incubation. Bone marrow cultures produce a higher yield.

Treatment

Antibiotic therapy with doxycycline + rifampin or doxycycline in combination with other medications for six weeks is usually sufficient in most cases. More prolonged regimens may be required for patients with more serious complications.

Preventative Measures

There is no human vaccine available against brucellosis, although animal vaccines exist. Drug treatment is not recommended after possible exposure to endemic disease. Treatment should only be considered for high-risk exposure to confirmed biological warfare exposure.

Isolation and Decontamination

Standard precautions are appropriate for healthcare workers. Person-to- person transmission has been reported via tissue transplantation and sexual contact. Environmental decontamination can be accomplished with a 0.5% hypochlorite (household bleach) solution (nine parts water to one part Clorox).