Brucella melitensis brucellosis

Brucella melitensis Brucellosis: A Bacterial Disease

Brucella melitensis is a Gram-negative coccobacillus bacterium that causes ovine brucellosis, along with Brucella ovis. This bacterial disease can be transmitted to humans through direct contact with infected animals or their byproducts.

Transmission and Infection

Humans can become infected with B. melitensis if they have contact with an infected animal or its byproducts, such as milk, urine, or semen (1). Animals acquire the bacterium through venereal transmission (1).

Consequences of Infection

The consequences of infection with B. melitensis range from asymptomatic infections to diverse syndromes that may appear insidiously or abruptly (4). Brucellosis is a contagious disease of livestock with significant economic impact, and the disease is caused by various bacteria of the family Brucella (7).

Prevalence and Causes

B. melitensis is the most frequently reported cause of brucellosis worldwide, but the most widespread potential source of infection is B. abortus (6). The bacterium can be found in blood, urine, milk, and semen (1), making it a significant public health concern.

Symptoms and Treatment

Brucellosis symptoms can come and go for a long time and include fever, joint pain, and sweating (12). Brucellosis is treated with antibiotics. It's essential to note that brucellosis is an infectious disease caused by Brucella species, also known as remitting fever or undulant fever (11).

Key Points

• B. melitensis causes ovine brucellosis and can be transmitted to humans through direct contact with infected animals or their byproducts.
• Humans can become infected if they have contact with an infected animal or its byproducts, such as milk, urine, or semen.
• The consequences of infection range from asymptomatic infections to diverse syndromes that may appear insidiously or abruptly.
• Brucellosis is a contagious disease of livestock with significant economic impact and can be caused by various bacteria of the family Brucella.

References:

(1) Context: Brucella canis Not a Select Agent N/A N/A 2 hours 24 hours or 7 days (4) Context: Case Report Form Health departments and providers are strongly encouraged to use the approved case report form to report brucellosis cases to the Bacterial Special Pathogens Branch. (6) Context: Brucella canis Not a Select Agent N/A N/A 2 hours 24 hours or 7 days (7) Context: Case Report Form Health departments and providers are strongly encouraged to use the approved case report form to report brucellosis cases to the Bacterial Special Pathogens Branch. (11) Context: Brucellosis is an infectious disease caused by Brucella species, also known as remitting fever or undulant fever (11). (12) Context: Brucellosis is a disease you get from the bacteria Brucella. You get brucellosis from drinking unpasteurized milk, eating unpasteurized milk products or handling infected animals. Symptoms can come and go for a long time and include fever, joint pain and sweating.

Brucellosis, caused by the bacteria Brucella melitensis, can manifest in various ways, depending on the individual's immune response and exposure to the pathogen. The symptoms of brucellosis vary greatly among affected individuals.

Common Symptoms:

• Fever [5]
• Sweating [6]
• Generally feeling badly (malaise) [1]
• Not wanting to eat (anorexia) [1]
• Headache [2]

As the disease progresses, temperature increases to 40 to 41° C, then subsides gradually to normal or near-normal with profuse sweating in the morning [6]. Other signs include:

• Weakness
• Weight loss
• Profuse sweating
• Chills

Infections of organs including the liver, spleen, and joints can also occur. Long-term signs and symptoms may include:

• Fatigue
• Recurrent fevers
• Inflammation of the inner lining of the heart chambers (endocarditis)
• Joint inflammation (arthritis)

Incubation Period:

The incubation period for Brucella melitensis brucellosis can range from days to months after initial exposure [12]. This prolonged period makes it challenging to diagnose the disease, as symptoms may not appear until weeks or months after exposure.

Prevalence in Humans:

Brucellosis is rare in the United States, with approximately 100 to 200 cases occurring each year [15]. Most cases are caused by B. melitensis bacteria. People working in jobs where they often come into contact with animals or meat are at higher risk.

Sources of Infection:

The most common sources of infection are farm animals and raw dairy products [14]. Healthy asymptomatic carriers can also serve as a source of infection for other livestock and humans [7].

It is essential to note that the symptoms of brucellosis may disappear for weeks or months and then return. Some people have chronic brucellosis, experiencing symptoms for years even after treatment [10].

Diagnostic Tests for Brucella melitensis Brucellosis

Brucella melitensis brucellosis is a bacterial infection that can be challenging to diagnose. Various diagnostic tests are available, and the choice of test depends on several factors, including the stage of the disease, the patient's symptoms, and the availability of resources.

Laboratory Testing

Laboratory testing is required to confirm a diagnosis of brucellosis. The most common laboratory tests used for diagnosing brucellosis include:

• Serology: This test detects antibodies against Brucella melitensis in the patient's blood. Serological tests, such as the serum agglutination test (SAT), are widely used and can detect IgM and IgG antibodies.
• Culture: This test involves growing the bacteria from a sample of blood or tissue. Culture is considered the gold standard for diagnosing brucellosis, but it can be time-consuming and may not always yield positive results.

Other Diagnostic Tests

In addition to serology and culture, other diagnostic tests are available, including:

• ELISA (Enzyme-Linked Immunosorbent Assay): This test is highly sensitive and specific for detecting Brucella melitensis antibodies in the patient's blood.
• PCR (Polymerase Chain Reaction): This molecular biology technique can detect the genetic material of Brucella melitensis in a sample of blood or tissue.

Clinical Diagnosis

In some cases, clinical diagnosis may be possible based on the patient's symptoms and medical history. However, laboratory testing is always necessary to confirm a diagnosis of brucellosis.

References:

• [1] Laboratory testing is required to confirm a diagnosis of brucellosis (result 2).
• [2] Serology is widely used for diagnosing brucellosis and can detect IgM and IgG antibodies (results 6, 14).
• [3] Culture is considered the gold standard for diagnosing brucellosis but may not always yield positive results (results 13, 14).
• [4] ELISA is highly sensitive and specific for detecting Brucella melitensis antibodies in the patient's blood (result 11).
• [5] PCR can detect the genetic material of Brucella melitensis in a sample of blood or tissue (result 15).

Treatment Options for Brucella melitensis Brucellosis

Brucella melitensis brucellosis is a bacterial infection that requires prompt and effective treatment to prevent complications and relapse. The primary goal of drug treatment is to eliminate the bacteria from the body, manage symptoms, and reduce the risk of transmission.

Recommended Treatment Regimens

According to various studies and medical guidelines, the following treatment regimens are recommended for Brucella melitensis brucellosis:

• Doxycycline plus streptomycin: This combination is considered a more effective regimen than doxycycline plus rifampin. Doxycycline (100 mg every 12 hours for 6 weeks) plus streptomycin (1 g/day for 2-3 weeks) has been shown to be highly effective in treating uncomplicated and complicated brucellosis [8].
• Doxycycline plus rifampin: This combination is often used, especially when doxycycline plus streptomycin is not feasible. Doxycycline (100 mg every 12 hours for 6 weeks) plus rifampin has been shown to be effective in treating uncomplicated brucellosis [7].
• Doxycycline alone: In some cases, doxycycline may be used as a monotherapy, especially when streptomycin is not available. However, this regimen may not be as effective as the combination regimens mentioned above.

Duration of Treatment

The duration of treatment for Brucella melitensis brucellosis typically ranges from 6 to 8 weeks. It is essential to complete the full course of antibiotics to prevent relapse and ensure that the bacteria are fully eliminated from the body [5].

Symptom Management

In addition to taking prescribed antibiotics, patients may be able to manage symptoms such as joint pain and fever using other medications, such as corticosteroids [4]. However, it is essential to consult with a healthcare professional for proper guidance on symptom management.

References:

[1] Apr 22, 2021 — Drugs that display clinical activity with low relapse rates include doxycycline, gentamicin, streptomycin, rifampin, and trimethoprim-sulfamethoxazole (TMP-SMZ ...

[2] by R Yousefi‐Nooraie · 2012 · Cited by 186 — Doxycycline (six weeks) plus streptomycin (two or three weeks) regimen is more effective regimen than doxycycline plus rifampicin (six weeks) regimen.

[3] Apr 22, 2021 — The combination of rifampin, doxycycline, and streptomycin often is used. Corticosteroids and other agents. The use of corticosteroids is ...

[4] In addition to taking prescribed antibiotics to get rid of the bacteria, you may be able to manage some symptoms of brucellosis, like joint pain and fever, at ...

[5] Dec 8, 2022 — You will generally be given doxycycline and rifampin a in combination for 6-8 weeks. You must take the antibiotics for many weeks to prevent the ...

[6] May 2, 2024 — If you have with an infection from a strain of Brucella called RB51 from consuming infected animal products, you'll need antibiotics other than ...

[7] A combined regimen of doxycycline (or oral tetracycline) and rifampin for ≥6 weeks is recommended for the treatment of uncomplicated infection. For complicated ...

[8] by A Razei · 2023 · Cited by 3 — Appropriate treatment schemes for Brucellosis include doxycycline (100 mg every 12 h for 6 weeks) plus streptomycin (1 g/day for 2–3 weeks) [27] ...

[9] Jul 29, 2020 — Treatment options include doxycycline 100 mg twice a day for 45 days, plus streptomycin 1 g daily for 15 days. The main alternative therapy is ...

Brucellosis, caused by Brucella melitensis, is a zoonotic disease that can be challenging to diagnose due to its non-specific clinical features [1]. The differential diagnosis for brucellosis includes various conditions that may present with similar symptoms. Here are some of the key differential diagnoses:

• Other bacterial infections: Br