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Brucellosis

Malta Fever, Undulant Fever, Bang's Disease

Basic Information

What is Brucellosis?

Brucellosis is a bacterial disease that presents with fever and vague symptoms. It is transmitted to humans from animals, especially cattle and pigs, through consuming infected, unpasteurized milk or cheese, or contact with infected meat. The incubation period varies from days to several weeks. Brucellosis is now rare in the US, except in Midwestern states or in visitors from countries where brucellosis is common.

Brucellosis signs and symptoms

In the acute form, the following symptoms appear suddenly:

  • Chills, intermittent fever, sweating.
  • Marked fatigue.
  • Tenderness along the spine.
  • Headache.
  • Enlarged lymph glands.

In the chronic form, the following symptoms appear gradually:

  • Fatigue.
  • Muscle pain.
  • Backache.
  • Constipation.
  • Weight loss.
  • Depression.
  • Sexual impotence.
  • Abscesses in the ovaries, kidney and brain (rare).

Causes

Infection from the bacteria, Brucella, which is transmitted to humans through unpasteurized milk or milk products (butter, cheese) or meat products.

Risk increases with

  • Pernicious anemia or previous stomach surgery. These conditions result in reduced stomach acid; stomach acid decreases the chance of infection.
  • Persons with occupations involving animals, such as farmers, butchers, veterinarians or ranchers.
  • Travel to some foreign countries.

Preventive measures

  • Don't drink unpasteurized milk from any source.
  • Use gloves, goggles, aprons and other protective measures when working around animals.
  • Immunization of livestock.

Expected outcomes

The prognosis for brucellosis is good. With combination therapy, even wide-spread infections may be cured or controlled.

Possible complications

The most frequent complications involve infection of the vertebrae (spondylitis), the heart (endocarditis), brain (meningoencephalitis), or the joints (arthritis). Less commonly, inflammation of the lungs (pneumonitis), liver (hepatitis), or gall bladder (cholecystitis) are observed.

Brucellosis treatment

General measures

  • A definite diagnosis is made from blood tests.
  • Treatment consists of a period of bed rest and antibiotic therapy.
  • It usually is not necessary to isolate the ill person.
  • All family members who may have been exposed to the same infected milk products should have medical checkups and diagnostic tests.

Medications

  • Antibiotics to fight infection, such as tetracycline, for a minimum of 3 weeks.
  • Cortisone drugs to reduce the inflammatory response in severe cases.
  • Pain relievers for muscle pain.
Information
Brand
Generic
Label
http://www.nmihi.com/c/ciprofloxacin.html
Cipro
Ciprofloxacin
Off-Label
Azithromycin
Zithromax
Azithromycin
Off-Label
http://www.nmihi.com/t/co-trimoxazole.html
Bactrim
Co-trimoxazole
Off-Label
Co-amoxiclav
Augmentin
Amoxicillin/Clavulanate
Off-Label
Principen pills
Principen
Ampicillin
Off-Label
Adoxa
Doxycycline
On-Label
Sumycin
Tetracycline
On-Label

Activity

Rest in bed until fever and other symptoms subside. Resume your normal activities gradually.

Alternatives

Other acute, fever-producing illnesses are Q fever, influenza, mononucleosis, tularemia, and enteric fever; the recurring fever of brucellosis sets it apart, however. Chronic brucellosis may resemble Hodgkin's disease, tuberculosis, AIDS, malaria and some fungal infections, such as coccidioidomycosis and histoplasmosis.

Diet

No special diet. Increase calories if weight loss has been significant.

Appropriate specialists

Infectious disease specialist, neurologist, cardiologist, and orthopedist.

Notify your physician if

  • You or a family member has symptoms of brucellosis.
  • Fever or other symptoms recur after treatment.

Last updated 31 March 2018