brucellosis symptoms. brucellosis symptoms. Signs of brucellosis, treatment. All human organs and systems can be affected
![brucellosis symptoms. brucellosis symptoms. Signs of brucellosis, treatment. All human organs and systems can be affected](https://i2.wp.com/xn----7sbafhemardcsgryiif5cu.xn--p1ai/bitrix/images/brutsellez-3.jpg)
Brief historical information
The disease has been known since the time of Hippocrates, but its scientific study began only in the 60s of the XIX century (J. Marston, 1859). At that time it was called "Mediterranean or Maltese fever". The causative agent of brucellosis was first discovered by D. Bruce (1886), who gave the bacterium the name Micrococcus melitensis. Later, Bang and V. Stribold identified similar microorganisms (V. abortus) in infectious abortions in cows (1897), and J. Traum in pigs (V. suis, 1914). In 1920, the bacteria were combined into one genus, named after D. Bruce Brucella, and the disease they caused was called brucellosis. Later, new species of Brucella were isolated - B. neotomae (1957), B. ovis and B. canis (1970).
Serological studies in brucellosis were started by A. Wright and D. Semple (1897). The Wright agglutination test (RA) subsequently acquired great importance in the laboratory diagnosis of the disease.
What causes brucellosis
pathogens- aerobic and microaerophilic immobile gram-negative bacteria of the genus Brucella. According to the international classification, the genus Brucella consists of 6 independent species, which are divided into a number of biovars. Brucella are distinguished by pronounced polymorphism: cocci and elongated rods are observed in one preparation. B. melitensis is more often represented by coccoid forms, B. abortus and B. suis - sticks with rounded ends. The most common lesions in humans are caused by B. melitensis, represented by 3 biovars (the main hosts are sheep and goats). Somewhat less often - B. abortus, represented by 9 biovars (the main host is cattle), and B. suis, represented by 4 biovars (the main hosts are pigs, hares, reindeer). In rare cases, lesions in humans are caused by B. canis (the main host is dogs).
Determination of the species and biovars of Brucella in specific areas and in the foci of infection is of great epidemiological and epizootological significance in terms of classifying foci, assessing the degree of intensity of the epidemic and epizootological processes, establishing the facts of migration of Brucella from one animal species to another, identifying ways of spreading the pathogen, choosing tactics treatment, etc.
Epidemiology
Main source and reservoir of infection- Sheep, goats, cattle and pigs. Cases of infection of people with brucellosis from reindeer have been noted. In rare cases, the source of infection can be horses, camels, yaks and some other animals that excrete the pathogen with milk, urine, feces, amniotic fluid. Brucellosis is most commonly transmitted to humans from small livestock, the causative agent of which (B. melitensis) causes most of the severe forms of the disease. Also, quite often a person becomes infected with B. abortus from cattle, however, a clinically significant infection is recorded in isolated cases. The course of the disease is mild; a sick person is not dangerous to others.
Pathogen transmission mechanism varied, most often fecal-oral; contact-household (when the pathogen enters damaged skin and mucous membranes) and aerogenic transmission mechanisms are also possible. The epidemic significance of food products and raw materials of animal origin is determined by the massiveness of contamination, the type of pathogen, and the duration of its preservation. Raw dairy products (milk, feta cheese, cheese, koumiss, etc.), meat and raw materials (wool, astrakhan fur and skin) from goats and sheep with brucellosis pose the greatest danger. Meat poses a significantly lower epidemiological hazard, since it is usually consumed after heat treatment. However, in some cases, with insufficient heat treatment (national characteristics of cooking - stroganina, barbecue with blood, raw minced meat, etc.), meat and meat products can cause brucellosis infection.
Sick animals contaminate soil, bedding, feed, water with brucella, which in turn become factors that cause human infection. Cases of human infection during manure cleaning have been registered. The aspiration route of infection is possible by inhalation of an air-dust mixture containing infected fragments of wool, manure, and earth. This route of infection is possible when shearing, sorting wool, combing out fluff (development, knitting, etc.), as well as when cleaning rooms and territories where animals are kept or raw materials are processed from them. In this case, brucella can also penetrate the mucous membrane of the conjunctiva of the eyes. Cases of laboratory aerogenic contamination are possible when working with bacterial cultures. Cases of infection of people through water are known, but the epidemiological significance of this route of transmission is small. Intrauterine infection of the fetus and infection of children during breastfeeding are possible.
Natural susceptibility of people high. Post-infection immunity usually lasts 6-9 months. Repeated diseases are observed in 2-7% of cases.
Main epidemiological signs. Brucellosis is a ubiquitous infection; foci of the disease have been identified on all continents. At the same time, it is characterized by a pronounced professional nature of the incidence: it is most common in rural areas among livestock workers. Morbidity in humans is closely related to epizootics among cattle, sheep and goats. A significant place in some cases is occupied by the possibility of migration of Brucella from a biologically adapted host to other animals. Migration is most often facilitated by joint keeping or joint grazing of different animal species. The greatest danger is represented by the migration of B. melitensis to cattle. Mostly people who work with animals get sick: shepherds, shepherds, milkmaids, veterinary and zootechnical workers, employees of bacteriological laboratories, workers of meat processing plants, slaughterhouses, and wool processing factories. Infection can occur during the processing of raw meat, skin, wool of animals with brucellosis. In such cases, the penetration of Brucella into the human body occurs through the skin, mucous membranes of the eye, nose, and oral cavity. In a laboratory examination of livestock breeders, 1.5-2% of individuals with antibodies to brucellosis pathogens are detected. The prevalence of brucellosis is not the same in the regions, it is recorded mainly in livestock areas. Epizootics and a high incidence of brucellosis persist in the CIS countries, mainly in Kazakhstan and Central Asian countries, from which infected raw materials may enter Ukraine. The maximum number of cases of brucellosis of the goat-sheep type falls on the spring-summer period. When infected with brucellosis from cattle, seasonality is less pronounced, which is explained by a long lactation period and infection mainly through milk and dairy products.
Pathogenesis (what happens?) during Brucellosis
Brucella enter the human body through mucous membranes or damaged skin, leaving no changes in the area of the entrance gate. By the lymphogenic route, the pathogens are brought into the regional lymph nodes and accumulate in them. This phase of the course of infection is called lymphogenous and corresponds to the incubation period of the disease. Its duration can be different and depends on the ratio of the activity of pathogens (infective dose) and the body's defenses. With long-term preservation of brucella in the lymph nodes, an immunological restructuring of the body occurs, antibodies detected in serological reactions accumulate, a skin allergic test with brucellin becomes positive, but clinical manifestations do not develop (primary latency phase).
It is followed by the hematogenous phase (the phase of hematogenous drift). Bacteremia and endotoxinemia develop, clinical symptoms of acute brucellosis appear. These manifestations are associated with functional disorders of the autonomic nervous system under the influence of endotoxin and toxic-allergic reactions.
The possibility of long-term persistence of pathogens inside macrophages is explained by the incompleteness of phagocytosis and the slow development of immune response reactions. Easily occur metastatic foci of reproduction of Brucella in organs with the development of localized infiltrates; the clinical picture shows signs of focal lesions of the musculoskeletal, nervous and other systems. Subsequent episodes of the release of pathogens into the bloodstream support bacteremia and endotoxemia, give the disease a wave-like character. These mechanisms develop in the phase of subacute brucellosis, but in some cases, focal lesions form early, even at the stage of acute brucellosis.
The disease is prone to a long course and the transition to a chronic state. Long-term preservation of pathogens in metastatic foci with episodes of re-dissemination and the development of reactive-allergic changes underlies chronic brucellosis (the phase of exo-focal contamination and reactive-allergic changes). In a chronic process, the pathogenetic significance of bacteremia and endotoxinemia, the activity of inflammatory-allergic organ focal reactions, weakens. The formation of new inflammatory foci is associated primarily with autoimmune mechanisms.
In chronic brucellosis, functional and sometimes irreversible organic disorders develop in various organs and systems with the development of persistent cicatricial changes. They persist even after complete reorganization of the body and in these cases underlie the pathogenesis of the phase of the so-called residual metamorphosis (phase of outcome and residual effects). Functional disorders are characterized by the scarcity of objective symptoms with an abundance of subjective complaints.
Symptoms of Brucellosis
Incubation period equal to 1-4 weeks, but can be extended up to 2-3 months with the development of a latent infection. According to the modern clinical classification based on the generally accepted classification of G.P. Rudnev, there are acute (lasting up to 1.5 months), subacute (up to 4 months), chronic (more than 4 months) and residual (clinic of consequences) forms.
Acute brucellosis. It can develop gradually (more often in the elderly) or quickly. With a gradual onset of the disease over various periods of time (from several days to several weeks), patients complain of malaise, weakness, sleep disturbances, decreased performance, pain in the joints, various muscle groups and lower back. During the examination, subfebrile condition is noted, sometimes an increase in peripheral lymph nodes by the type of micropolyadenopathy. In the future, signs of intoxication gradually increase, the body temperature becomes high, chills and heavy sweats appear, the liver and spleen increase in size.
With rapid development, acute brucellosis is manifested by a rise in body temperature to high numbers (39 ° C and above) during the first 1-2 days of the disease. A fever of a remitting, undulating or intermittent nature is accompanied by severe chills, culminating in profuse sweating. The febrile reaction usually lasts for several days, but can be extended up to 3-4 weeks, taking on a wave-like character. At the same time, in most cases, the state of health of patients due to moderate intoxication remains relatively satisfactory even against the background of high body temperature and fairly significant objective changes. This clinical feature, characteristic of brucellosis, often causes difficulties in the differential diagnosis of the disease.
Patients complain of headache, emotional instability, irritability, sleep disturbances, muscle and joint pain. When viewed at the height of fever, hyperemia of the face and neck, pallor of the skin of the trunk and extremities are noted. Peripheral lymph nodes, especially cervical and axillary, slightly increase in size, may be somewhat painful on palpation. Micropolyadenopathy, which is considered an early clinical sign of brucellosis, has recently been encountered infrequently (no more than 20-25% of cases). Sometimes in the subcutaneous tissue, but more often in the area of \u200b\u200bmuscles and tendons, painful dense nodules or nodes ranging in size from a pea to a small chicken egg can be palpated - fibrositis and cellulitis, although their appearance in patients is more typical for the next, subacute form of brucellosis. The liver and spleen are enlarged, sensitive to palpation. In 10-15% of cases, already in the acute period of the disease, organ lesions of the musculoskeletal system, genital area, and peripheral nervous system develop with corresponding focal symptoms.
The severity of brucellosis largely depends on the type of pathogen (its virulence). Usually, diseases caused by B. abortus are milder than those caused by B. melitensis.
Subacute form. It is characterized by a relapsing course. Feverish periods with a temperature reaction of varying severity and duration (usually for several days) alternate with periods of apyrexia. During the rises, the temperature curve becomes irregular, the temperature level is subject to significant fluctuations even during the day.
Patients show numerous various complaints. Disturbed by diffuse pain in muscles, bones and joints, paresthesia, depressed mood. Sleep and appetite worsen, muscle weakness develops, dry mouth, thirst, and constipation appear.
When examining patients, fibrositis and cellulitis are often detected. On the part of the cardiovascular system, relative bradycardia is noted at the height of fever and slight tachycardia during periods of normal body temperature, muffled heart sounds. In severe cases, signs of infectious-allergic myocarditis, endocarditis and pericarditis can be detected. Pathology of the respiratory organs is rarely detected (catarrhal tonsillitis, pharyngitis, bronchitis, bronchopneumonia). Changes in the digestive organs are functional, which is reflected in the complaints of patients. In severe cases, meningismus and sluggish serous meningitis may develop.
Much more often than in acute brucellosis, multiple organ lesions and allergic reactions develop (exanthema, dermatitis, reactions from the surface vessels of the skin, etc.). First of all, lesions of the musculoskeletal system are observed: arthritis and polyarthritis, synovitis, bursitis, tendovaginitis, etc. Typical lesions of the genital area - in men, orchitis and epididymitis, in women, menstrual disorders, endometritis, spontaneous abortions. Damage to the nervous system can manifest itself in the form of plexitis, ischioradiculitis.
Chronic brucellosis. Characterized by variability of clinical manifestations and relapsing course. The temperature reaction and other manifestations of intoxication are weak or moderately pronounced. Periods of exacerbations are replaced by remissions, the duration of which can reach 1-2 months. Deterioration is observed when fresh focal processes occur.
The clinical picture of chronic brucellosis is dominated by focal lesions from various organs and systems.
Signs of changes in the musculoskeletal system are characterized by the development of recurrent, long-term arthritis with frequent involvement of periarticular tissue (periarthritis), bursitis, tendovaginitis, periostitis, perichondritis. Typical fibrositis and cellulitis in the lumbosacral region and over the elbow joints. Lesions of various parts of the spine are manifested by severe pain, limitation of movement, deformities, and destructive changes.
Lesions of the nervous system are expressed in the form of radiculitis, plexitis, intercostal neuralgia, neuritis of the auditory and optic nerves, and sensitivity disorders. In rare cases, the development of meningoencephalitis, diencephalic syndrome is possible. Changes in the autonomic nervous system cause hyperhidrosis, the phenomena of vegetative-vascular dystonia. Neuroses and reactive states are often formed ("difficult character" of patients).
Urogenital pathology is manifested by orchitis and epididymitis in men, oophoritis, salpingitis, endometritis and menstrual disorders in women. Characterized by miscarriage, dysmenorrhea, infertility.
In chronic brucellosis, complex organ lesions (mixed form) most often develop.
Chronic active brucellosis can last up to 2-3 years, and with repeated infection - much longer. Its transition to a chronic inactive form is characterized by the absence of the formation of fresh foci and intoxication, the predominance of functional disorders, the long-term preservation of serum antibodies and a positive skin-allergic test (Burne test).
Consequences of brucellosis (residual brucellosis). They persist in the absence of the pathogen in the human body. Residual effects are characteristic, mainly of a functional nature due to immunoallergic restructuring and disorders of the autonomic nervous system: sweating, irritability, changes in the neuropsychic sphere, arthralgia, and sometimes subfebrile condition.
At the same time, more severe consequences of brucellosis may be associated with the development of irreversible fibro-cicatricial changes involving nerve trunks, plexuses, roots, which provokes the appearance of a variety of neurological symptoms.
Organic changes in the musculoskeletal system, sometimes developing in those who have had brucellosis (deformities of the joints, ankylosis, contractures, muscle atrophy, spondylosis), in some cases require surgical treatment and determination of the disability group.
In conclusion, it should be noted that the course of the disease at the present stage is distinguished by a number of features:
- febrile reaction of the wrong type is more often limited to subfebrile condition;
- lesions of the musculoskeletal system are manifested primarily by pain reactions, less often by focal inflammatory processes;
- lymphadenopathy and enlargement of the spleen develop in no more than 25% of cases;
- focal lesions develop earlier, in 12-15% of cases already during the period of acute brucellosis;
- Organic lesions of the central nervous system are rarely observed;
- lesions of the visceral organs in chronic brucellosis are usually manifested by disorders of the cardiovascular system;
- residual brucellosis occurs mainly with functional rather than organic disorders.
Diagnosis of brucellosis
Acute brucellosis is differentiated from diseases accompanied by prolonged fever (typhoid-paratyphoid diseases, malaria, tuberculosis, nonspecific systemic diseases, HIV infection, sepsis, lymphogranulomatosis, etc.). In acute brucellosis, an incorrect character of the temperature curve, the appearance of micropolyadenopathy, chills, sweating, an increase in the size of the liver and spleen are noted. In some cases, during this period of the disease, fibrositis and cellulitis are detected. The severity of clinical symptoms (especially high body temperature) is characteristic with a fairly satisfactory state of health. In subacute and chronic brucellosis, it is necessary to exclude rheumatism and rheumatoid arthritis, tuberculous focal lesions, syphilitic and gonorrheal arthritis. In these forms of brucellosis, periods of elevated body temperature alternate with episodes of apyrexia, the complaints of patients are numerous and varied (pain in the joints, muscles, bones, paresthesia, etc.); focal multiple organ manifestations and allergic reactions, fibrositis and cellulitis are characteristic.
Laboratory diagnosis of brucellosis
To isolate the pathogen, blood cultures, punctates of the lymph nodes, cerebrospinal fluid, and bone marrow are performed. Due to the high contagiousness of Brucella, bacteriological diagnostics can only be carried out in specially equipped ("regime") laboratories. Isolation of pathogens is rarely carried out due to the duration and complexity of the cultivation of the pathogen, as well as the relatively low seeding rate.
Recently, the reaction of aggregate hemagglutination, RCA and RLA, ELISA, which detect Brucella antigens in biological media (primarily in the blood), has been introduced into practice.
Widely used serological tests (Wright's RA, RSK, RNGA, RIF), revealing an increase in titers of specific antibodies in paired sera, the value of which increases in the presence of clinical signs of brucellosis. In chronic brucellosis, incomplete antibodies are detected in the Coombs reaction. The Wright reaction is most informative in acute brucellosis. Recently, the reaction of lysis of Brucella under the influence of the patient's blood serum has been successfully used.
The intradermal allergic test of Burne with the introduction of brucellin (a protein extract of the brucella broth culture) is widespread. Taking into account the time required for the growth of specific sensitization of the body to Brucella antigens, its setting is recommended not earlier than 20-25 days from the onset of the disease. The test is considered positive if the edema diameter is more than 3 cm; the development of hyperemia and soreness at the injection site of brucellin is optional. A positive Burne test is observed in all forms of brucellosis, including the latent course of the infectious process; it persists for years after convalescence. The test can also be positive in persons vaccinated with a live brucellosis vaccine, and in laboratory workers who have been in contact with Brucella antigens for a long time.
With the introduction of brucellin, an additional sensitization of the body occurs, and a pronounced local reaction (necrosis) may occur. In order to avoid these phenomena, reactions of neutrophil damage and leukocytolysis are introduced into practice. They are placed with the patient's blood in a test tube without introducing the allergen into the body.
Brucellosis Treatment
The mode is outpatient in the lungs and inpatient in severe cases of the disease. Etiotropic therapy is effective in acute brucellosis; a lesser effect is observed when the process is activated in patients with subacute and chronic forms. It is considered optimal to prescribe two antibiotics, one of which must penetrate the cell membrane. Apply one of the following combinations, taking into account contraindications (children under 15 years of age, pregnancy, lactation, epilepsy).
- Rifampicin (600-900 mg / day) and doxycycline (200 mg / day) orally in a continuous course, lasting at least 6 weeks. In case of relapse, the course of treatment is repeated.
- Doxycycline (100 mg 2 times a day) for 3-6 weeks and streptomycin (1 g intramuscularly 2 times a day) for 2 weeks. This combination is more effective than the previous one, especially in spondylitis, but the drugs used are highly toxic.
- Ofloxacin (200-300 mg 2 times a day) orally and rifampicin in the above doses.
The duration of the use of drugs explains the feasibility of monitoring their intake by patients.
In the complex therapy of brucellosis, detoxification agents are used according to the general principles of their use, ATP, methionine, mild immunostimulants (dibazole, pentoxyl, thymalin, etc.). Widely used anti-inflammatory drugs - non-steroidal anti-inflammatory drugs (indomethacin, brufen, etc.). For pain (neuritis, neuralgia, pain of a vegetative nature), symptomatic therapy is carried out in the form of novocaine blockades with a 1% solution of novocaine, intravenous injections of a 0.25% solution of novocaine in increasing doses.
The use of glucocorticoids should be carried out with great caution. Their appointment is involuntary with lesions of the central nervous system (meningitis, meningoencephalitis), as well as with pronounced inflammatory changes (orchitis, neuritis, etc.) and the absence of the effect of other anti-inflammatory drugs.
The therapeutic (killed) brucellosis vaccine has been used less and less in recent years for the treatment of patients because of its ability to cause immune suppression, increase the possibility of relapses, cause autoimmune reactions and reactions to the ballast substances contained in it.
During the period of stable remission in the chronic form and residual brucellosis, physiotherapy exercises, physiotherapy and spa treatment (UHF, quartz, paraffin applications, radon baths) are prescribed.
Prevention of Brucellosis
Epidemiological surveillance based on the results of an assessment of the epizootic and epidemic situation. In this regard, in organizing and conducting anti-brucellosis activities, an important role is played by the timely exchange of information and the joint activities of the veterinary and sanitary and epidemiological services to identify diseases among animals and humans and assess risk factors for their occurrence.
Prevention and control of brucellosis is based on a complex of veterinary-sanitary and medical-sanitary measures aimed at reducing and eliminating the incidence of brucellosis in farm animals. The livestock of animals in disadvantaged areas must be systematically examined for brucellosis using serological and allergological tests for the timely detection and elimination of diseased animals. As an auxiliary measure, in regions endemic for brucellosis, active immunoprophylaxis of brucellosis in animals is carried out by introducing a live vaccine. Vaccinations are also subject to permanent and temporary workers in animal husbandry, as well as workers in meat processing plants. Of great importance are the neutralization of raw materials and livestock products, the boiling and pasteurization of milk and dairy products, and other measures. Particular attention is required to the premises where livestock is kept. After removal of manure or removal of aborted fetuses and placenta, the room should be disinfected with a 20% solution of bleach, 2% formaldehyde solution or 5% solution of a soap-creosol mixture. Adolescents, pregnant women and persons suffering from chronic diseases are not allowed to work in the care of animals. All persons allowed to work with animals must be provided with overalls, and the ability to use disinfectants is also necessary. Strict observance of the rules of personal hygiene is of great importance. At the same time, a systematic preventive examination of personnel involved in working with animals is carried out (at least once a year). An important role is played by explanatory work about the dangers of eating raw milk and unaged cheeses and feta cheese, the use of animal hair from farms that are unfavorable for brucellosis.
Activities in the epidemic focus
Hospitalization of patients is carried out only according to clinical indications, since a sick person does not pose an epidemiological danger. Dispensary observation of the ill person is carried out within 2 years after clinical recovery. Persons in contact with sick animals are subject to clinical and laboratory examination, repeated after 3 months. As an emergency prophylaxis, rifampicin (0.3 g 2 times a day), doxycycline (0.2 g 1 time a day), tetracycline (0.5 g 3 times a day) are prescribed orally for 10 days.
Which doctors should you contact if you have Brucellosis
Infectionist
Promotions and special offers
Medical news 25.04.2019
A long weekend is coming, and many Russians will go on vacation outside the city. It will not be superfluous to know how to protect yourself from tick bites. The temperature regime in May contributes to the activation of dangerous insects ...
05.04.2019
The incidence of whooping cough in the Russian Federation in 2018 (compared to 2017) almost doubled1, including in children under 14 years of age. The total number of reported cases of whooping cough in January-December increased from 5,415 cases in 2017 to 10,421 cases in the same period in 2018. The incidence of whooping cough has been steadily increasing since 2008...
20.02.2019
Chief pediatric phthisiologists visited the 72nd school in St. Petersburg to study the reasons why 11 schoolchildren felt weak and dizzy after they were tested for tuberculosis on Monday, February 18
Medical Articles
Almost 5% of all malignant tumors are sarcomas. They are characterized by high aggressiveness, rapid hematogenous spread and a tendency to relapse after treatment. Some sarcomas develop for years without showing anything ...
Viruses not only hover in the air, but can also get on handrails, seats and other surfaces, while maintaining their activity. Therefore, when traveling or in public places, it is advisable not only to exclude communication with other people, but also to avoid ...
Returning good vision and saying goodbye to glasses and contact lenses forever is the dream of many people. Now it can be made a reality quickly and safely. New opportunities for laser vision correction are opened by a completely non-contact Femto-LASIK technique.
Cosmetic preparations designed to care for our skin and hair may not actually be as safe as we think.
Brucellosis affects the joints, nervous system, heart and blood vessels of the patient. In nature, the pathogen exists in the blood of livestock - cows, sheep, goats. Infection of a person occurs during lambing or calving of animals, as well as through the use of raw milk, undercooked meat. Dangerous contact with wool when shearing animals, when the infection penetrates the respiratory tract. The disease is not transmitted from person to person.
Brucellosis in humans usually occurs in the form of epidemics, in winter and spring. Most often, children aged 7-12 get sick.
Once in the body, the pathogen enters the lymph nodes, and from there it spreads to the liver, spleen, and bone marrow. In these organs, it can exist for a long time, causing a chronic allergic reaction. The infection causes widespread inflammation of the vessels. The disease has a chronic course with relapses.
There are mild, moderate and severe forms, as well as erased and asymptomatic. The disease occurs acutely, fever, muscle and joint pain appear. With a gradual subacute lesion, weakness first occurs, and then an increase in body temperature.
How to determine the pathology by external signs: in 2-3 weeks after contact with animals, the temperature suddenly rises in the patient, pain in the joints, sweating, lymph nodes increase. Then the internal organs are involved.
With this disease, various skin rashes occur.
Signs of the disease
The first signs of infection occur 1 to 5 weeks after the bacterium enters the respiratory or digestive organs. There is a headache, joint, muscle pain, weakness, lack of appetite and insomnia. There are chills and sweating. The strongest reaction of the body develops on the 5th - 7th day, when fever appears. At the same time, the lymph nodes increase, sweating is characteristic.
Signs of brucellosis include an enlargement of the liver and spleen by 2 to 3 cm. Pain in the knee and ankle joints is typical without signs of acute arthritis. Fibrositis or cellulitis develops - painful areas of muscles and subcutaneous tissue. The skin is pale, there are nosebleeds and various rashes on the body.
With a long course of the process, signs of pathology include myocarditis, bronchitis, pneumonia, meningitis and other complications. Changes in the musculoskeletal system are associated with joint pain and the development of sciatica, which makes movement difficult.
How to determine the pathology in a person: the doctor prescribes laboratory tests to identify the pathogen in the preparation. The material is isolated from blood, urine, sputum, lymph nodes and other media.
Chronic brucellosis
Conventionally, it is believed that chronic forms of the disease develop six months after the onset of the disease. However, in some patients, signs of chronicity occur earlier. In some, on the contrary, after six months or more, the process is still acute.
Chronic brucellosis is manifested by polyarthritis - multiple inflammation of the joints. The knee, hip, elbow joints, as well as the lumbosacral joint are affected. The disease is accompanied by prolonged pain, stiffness, stiffness and deformity of the joints. Liquid does not accumulate in them.
There are clinical manifestations of the pathology of the connective tissue, muscles (myositis, bursitis) and peripheral nerves (plexitis, polyneuritis). The pathogen can cause meningitis, arachnoiditis, damage to the optic and auditory nerves.
Symptoms of the chronic form include inflammatory diseases of the genital organs. So, women develop adnexitis, endometritis, abortion. Orchitis and epididymitis are typical for men. These diseases lead not only to a decrease in sexual desire, but also to infertility.
The disease has an undulating course. After the incubation period, an acute form occurs with intoxication, enlarged lymph nodes, and damage to internal organs. For example, in the first months of the disease, allergic myocarditis occurs. Then the active chronic form of the disease develops. This state flows in waves, gradually subsiding and turning into remission. In this case, the exacerbation may no longer develop, but the patient develops an irreversible deformity of the joints or a dysfunction of the internal organs.
The causative agent of the disease in the chronic form is found in the form of inactive L-forms. Serological methods are more commonly used. As a screening enzyme immunoassay is used.
How to identify pathology in humans: even with a long course, positive reactions of agglutination, complement coagulation and other diagnostic tests are noted in a patient. Chronic forms of the disease are treated with antibiotics.
Diagnosis of the disease
Chronic infectious process is reflected not only in clinical manifestations. Diagnosis of brucellosis takes into account the epidemiological situation, contact with animals. How to identify pathology: to confirm the diagnosis, it is necessary to isolate the pathogen.
How to diagnose brucellosis? For this, the infectious disease doctor prescribes cultures of biological fluids (blood, urine, effusion from the joints, sputum), as well as material from the lymph nodes on a nutrient medium. After the formation of colonies of microbes, their properties are examined and the diagnosis is confirmed.
The most effective analysis for pathology is the polymerase chain reaction (PCR). If it is positive, the diagnosis can be considered confirmed. Additionally, serological tests are used: agglutination and complement fixation reactions. Methods for rapid diagnosis of the disease: Huddleson agglutination test and immunofluorescent analysis.
Diagnosis and treatment of the disease are carried out in infectious hospitals. Although the patient is not contagious to others, he is concerned about fever, weakness, joint pain. These symptoms require antibiotic therapy under medical supervision.
In foci of infection, children over 7 years of age and agricultural workers are given the vaccine. Before its use, a thorough diagnosis of the disease is necessary, since the latent and chronic forms are a contraindication for vaccination.
To detect hidden disorders and latent forms, Burne's intradermal allergy test is used. It becomes positive a month after the onset of the disease and remains so for many years. It reflects the development of chronic sensitization of the body in response to microorganisms that can penetrate into the lymph nodes and accumulate there.
Symptoms of the disease
![](https://i2.wp.com/xn----7sbafhemardcsgryiif5cu.xn--p1ai/bitrix/images/brutsellez-3.jpg)
General signs of the disease are not specific and resemble the flu. Symptoms of brucellosis in humans:
- fever, especially in the afternoon;
- pain in the back and in the whole body;
- poor appetite, weight loss;
- headache;
- sweating at night;
- weakness;
- cough and chest pain;
- enlargement of the cervical lymph nodes;
- depression and irritability;
- abdominal pain caused by an enlarged spleen and liver;
- skin rash and microabscesses under the skin.
Symptoms of the disease appear within a month after infection. The severity of violations depends on the type of infection that causes the disease.
B. abortus causes mild to moderate changes, but they often become chronic. Signs of B. canis infection may come and go. There is a lesion of the mucous membranes with the development of diarrhea. B. suis causes the formation of purulent abscesses in the internal organs. B. melitensis is the cause of a severe reaction of the body and an acute onset of the disease.
As a result of complications, the following consequences may occur:
- endocarditis;
- sacroiliitis;
- osteomyelitis;
- infertility;
- thrombocytopenic purpura - a blood disease accompanied by bleeding;
- cerebellar ataxia;
- spinal syndrome;
- chronic hepatitis;
- miscarriages;
- intrauterine infection of newborns.
However, most patients recover completely after treatment.
Treatment of brucellosis
Antibacterial therapy is necessary to destroy the pathogen in the tissues. Treatment of brucellosis with antibiotics is carried out in a course for a week. In the acute period, the following drugs are prescribed:
- chloramphenicol;
- tetracycline;
- erythromycin;
- rifampicin.
Antibiotics are prescribed in a dosage corresponding to the age of the patient. After 2 weeks, the antibacterial treatment of the disease is repeated. Sometimes a third course is needed. These drugs destroy bacteria, but do not prevent exacerbations of the disease and the formation of a long chronic process.
How to treat brucellosis, in addition to antibiotics? In addition to them, vaccine therapy is used. A killed vaccine is administered. The course consists of 8-10 injections with an interval of 2-5 days.
How to treat the disease in severe or chronic disorders? Prednisolone is prescribed for a month, as well as a drug that affects the immune system - cycloferon. This helps to quickly relieve fever, pain, weakness and other manifestations of inflammation.
Symptomatic treatment with painkillers and anti-inflammatory drugs is indicated. Physiotherapy is prescribed (UHF, ozocerite, therapeutic mud), therapeutic exercises and massage, radon baths.
Depending on the involvement of other organs, a consultation with a cardiologist, pulmonologist, rheumatologist, neurologist and other specialists is prescribed.
Response to treatment is assessed by the appearance of the skin and joints, as well as by changes in blood tests.
Medical supervision is necessary for 2 years after recovery. Patients are examined 2 times a year, blood tests, serological reactions are carried out.
Disease prevention:
- improvement of domestic animals and their vaccination;
- thorough heat treatment of milk and meat;
- the introduction of children and workers engaged in agricultural work, live vaccines;
- the use of overalls and disinfectants at work;
- prevention of pollution of water sources by agricultural waste.
After vaccination, unstable immunity occurs. Therefore, in the event of an outbreak of the disease, the vaccine is administered again.
Treatment with folk methods
The disease in humans can take a long time, affecting the musculoskeletal system and the nervous system. To avoid this, timely full-fledged therapy is necessary. Treatment of brucellosis with folk remedies does not destroy the causative agent of the disease, but helps to reduce the severity of symptoms. The effectiveness of such methods helps to evaluate the blood test for pathology, which must be done after completion of therapy.
Alternative treatment of the disease is carried out by such methods:
- take 750 ml of carrot juice and 350 ml of pumpkin juice, mix, take half a glass before meals three times a day;
- collect birch leaves, buckthorn, willow bark, parsley root, mix and pour boiling water, boil for 20 minutes, take a glass 3-4 times a day;
- take only vegetable juice and water for 3 days;
- daily in the evening take a bath with coniferous concentrate or sea salt.
Traditional medicine offers many remedies for the treatment of pathology. Without the use of antibiotics, they will not help the patient, but only transfer the disease into a chronic form. Before using such prescriptions, you should consult your doctor.
Video about brucellosis
Brucellosis in humans develops through contact with infected animals. The disease is dangerous, because when infected, the musculoskeletal, cardiovascular, nervous, respiratory and other systems suffer. Timely diagnosis, adequate treatment and vaccination will help to avoid serious complications.
What is brucellosis
Brucellosis in animals is a dangerous infectious disease caused by Brucella, which is transmitted to humans. After infection in the body, bacteria begin to grow and multiply rapidly, malfunctions and inflammatory processes begin in various systems and organs, the immune system begins to work in an enhanced mode.
Brucella are aerobic, microaerophilic gram-negative bacteria, 6 types of pathogenic microorganisms are recorded in the international classification. The causative agents of the disease can penetrate even through an intact mucosa, they can live inside the cell or outside it.
The causative agent of the disease is very tenacious - it can survive in water for 2 months, in meat they remain viable for up to three months, and it lives on animal hair for about four months. Pathogenic microorganisms instantly die when boiled, do not tolerate bleach, chloramine.
The infection spreads in the human body through the blood vessels and lymph. Soon, new foci of inflammation appear in the liver, bone marrow, spleen, without proper treatment, serious consequences cannot be avoided. What the pathogens look like can be seen in the photo.
Note! The average duration of the incubation period in humans is 14-20 days, with a latent form - 3 months. Brucellosis code according to ICD-10 -A23.
Causes of the disease
Most often, brucellosis is diagnosed in goats, pigs, and cattle; pathogenic microorganisms are found in milk, urine, feces, and amniotic fluid.
Ways of human infection with animal brucellosis:
- Food - brucella enters the human body with meat, milk of sick animals, if hygiene rules are not followed after contact with feces.
- Contact household - bacteria enter the body from animal hair through damaged skin and mucous membranes.
- Aerogenous - a person inhales microparticles on which pathogens are located.
Note! Brucellosis in dogs is rare, a person can become infected from a sick pet. But in such cases, the disease proceeds in a mild form, there are no negative consequences.
How does brucellosis manifest?
In order for an infectious disease to begin to develop in a person, it is enough for 10 pathogenic microorganisms to enter the body. Symptoms of the disease depend on the state of the immune system, the age of the patient, the presence of chronic pathologies.
brucellosis symptoms:
- cephalgia;
- pain in muscles, joints, lumbar - develops, fibrositis;
- fever, fever - at the initial stage, the values \u200b\u200bdo not exceed the subfebrile mark, then they increase to 38.5–39 degrees;
- stool problems -,;
- sudden weight loss;
- enlargement of the liver, spleen;
- cervical, axillary, inguinal lymph nodes become dense, painful, their size increases to 6-7 mm, the condition of the skin does not change;
- vision deteriorates;
- depressive states.
Against the background of brucellosis, vision often deteriorates, develops,. The heart, blood vessels suffer, which manifests itself in the form of myocarditis, pericarditis,. Often an infectious disease is accompanied by damage to the nervous system - a person has signs, myelitis, intercostal.
Brucellosis negatively affects the reproductive system - men develop orchitis, the epididymis becomes inflamed. In women, inflammatory processes in the fallopian tubes and ovaries are diagnosed. All these pathologies can cause infertility.
Note! Sick people are not dangerous to each other, infection occurs exclusively from infected animals.
![](https://i1.wp.com/simptom-lechenie.ru/image/brycellez_2.jpg)
Forms of the disease
Depending on the severity of the clinical signs of brucellosis in humans, the stage of development of the pathology, there are several forms of pathologies, each of which requires special therapy.
Forms of brucellosis:
- Acute brucellosis - begins about 4 weeks after infection, lasts 1.5 months. It can develop quickly - the full clinical picture is manifested within a few days after the onset of the first symptoms. In older people, those with weakened signs of infection progress over several weeks. It is characterized by a very high temperature, 39-40 degrees, while the patient feels good. This form of the disease is the least dangerous, recovery is possible even without the use of potent drugs.
- Subacute brucellosis - clinical symptoms in a person do not disappear within 6-24 weeks. A distinctive feature - febrile conditions are undulating, there are signs of severe intoxication. At this stage, the lesions of internal organs and systems are functional in nature, if therapy is started on time, then complications will not arise.
- Chronic brucellosis - clinical signs appear for more than four months, the immune system is rebuilt, it begins to react differently to brucella, which leads to a decrease in temperature. Remission can last for several months, but the symptoms of the pathology do not completely disappear, they are more pronounced after each exacerbation. The prognosis for recovery is unfavorable, since the destructive processes in the tissues are irreversible.
Separately, a residual form of the disease is isolated, which occurs in people who have recovered from brucellosis - there are no bacteria in the body, but destructive processes in the internal organs continue due to malfunctions in the immune system. The disease is manifested by a frequent increase in temperature to subfebrile values, deformation of the musculoskeletal system. Surgery is required, which does not always improve well-being.
How to diagnose
The doctor can make a preliminary diagnosis after examining the patient, taking an anamnesis, but clinical diagnosis is necessary to exclude rheumatism, the presence.
The main methods of research on brucellosis:
- Clinical blood test - with inflammation, the level of leukocytes, monocytes increases, ESR slightly accelerates, and the level of neutrophils decreases. With the advanced form of the disease, all blood counts worsen.
- General urine analysis for brucellosis - determine the presence of protein and its amount.
- carried out to assess the condition of the liver.
These tests are necessary, but not very informative; additionally, it is necessary to conduct a specific blood test for brucellosis.
Serological and microbiological examination methods
The immune system produces antibodies to any pathogenic microorganisms, they penetrate into the bloodstream, capture only those bacteria and viruses against which they were synthesized. Therefore, with an increase in Brucella in the body, the level of specific antigens also increases, which can be determined using serological research methods.
Serological diagnostic methods:
- Wright's reaction - the analysis allows to detect the presence of bacteria already in the first few weeks after infection, the method is used to control the development of the acute period of brucellosis.
- Coombs reaction - allows you to identify incomplete antibodies (immunoglobulins) in the chronic stage of an infectious disease.
- Burne test - the minimum dose of brucellosis antigens is injected subcutaneously. If a person is healthy, has never had brucellosis, then there will be no reactions. Infected people develop severe allergic reactions within 1-2 days - the injection site of antigens will turn red, severe swelling and pain will appear. The test will be positive 20-30 days after infection, the disease can be detected even before the appearance of clinical signs.
Note! A comprehensive serodiagnosis is always carried out, which includes at least three tests.
Microbiological diagnostic methods are aimed at identifying pathogens in various tissues - they take blood for samples, make a puncture of the lymph nodes, cerebrospinal fluid. Because of the high potential for contamination, microbiology is used only as a last resort.
![](https://i0.wp.com/simptom-lechenie.ru/image/brycellez_3.jpg)
Effective Therapies
Treatment of brucellosis in humans is carried out in a complex manner, the choice of drugs depends on the form of brucellosis - it is necessary not only to eliminate the pathogenic microflora, but also to normalize the work of damaged organs, strengthen them. In therapy, potent drugs are used, they all have many side effects, so you need to take them strictly according to the instructions, follow all the rules and recommendations of the attending physician.
How to treat brucellosis:
- Antibacterial drugs - Gentamicin, Streptomycin, Doxycycline, Ofloxacin. You need to take medicines, according to the instructions, for a long time - 45–180 days, since bacteria quickly develop immunity to antibiotics, you need to drink several medicines at once.
- Anti-inflammatory drugs - Nimesil, Prednisolone.
- Immunostimulants - Dibazol, Pentoksil.
- Diuretics for the speedy cleansing of the body of toxins - Sorbitol.
After recovery, during remission, therapeutic and restorative physiotherapy is prescribed - paraffin applications, UHF, radon baths, electrophoresis, the doctor selects a special set of exercises.
Note! After treatment, immunity to brucellosis persists for 6–9 months, but re-infection is diagnosed in only 7% of patients.
![](https://i2.wp.com/simptom-lechenie.ru/image/brycellez_4.jpg)
brucellosis vaccinations
The vaccine against brucellosis contains weakened brucella - after its administration to the skin or subcutaneous, clinical symptoms of the disease will not occur, but the body will begin to produce antibodies against bacteria. Full immunity develops in a month, persists for 1-2 years.
Contraindications for vaccination:
- immunodeficiency states;
- tumors, blood diseases;
- elevated temperature;
- pregnancy, the period of breastfeeding;
- chronic diseases;
- serious dermatological pathologies, allergies.
All persons who belong to the risk group are subject to mandatory vaccination against brucellosis, provided there are no contraindications.
![](https://i0.wp.com/simptom-lechenie.ru/image/brycellez_5.jpg)
Complications
Brucellosis is a dangerous disease against which severe and fatal pathologies develop, they can only be avoided if you get vaccinated or start taking antibiotics within a month after infection.
Why is brucellosis dangerous?
- endocarditis - a serious violation of the functions of the heart valves, which can be fatal;
- arthritis - inflammation of an infectious nature in the joints, rapidly progressing, is chronic and irreversible;
- deformation of bones, joints;
- impaired motor activity due to bacterial damage to the spinal cord, peripheral nerve endings;
- inflammation of the liver and spleen;
- increased sweating;
- , - diseases almost always lead to disability or death of the patient;
- brucellosis during pregnancy is dangerous, premature birth, anomalies in the development of the fetus.
Note! The risk group includes veterinarians, travelers, hunters, farm workers, meat-packing plants, so men are most often ill with brucellosis. In children, the disease is rarely diagnosed.
Prevention
To prevent infection, simple precautions must be strictly observed. Since brucellosis is most often diagnosed in cows, goats, pigs, when caring for them, it is imperative to wear gloves and carefully treat your hands with antiseptics.
Can't eat raw milk, brucellosis bacteria most often lives in it, meat without proper heat treatment, all animals should be vaccinated in a timely manner.
Note! After contact with an infected animal, it is necessary to see a doctor for at least six months, even if there are no signs of the disease.
Brucellosis is a dangerous disease that requires long-term treatment, and full recovery may take several months. In order to prevent infection, it is necessary to follow simple rules of prevention, to vaccinate people who are at risk on time.
Update: October 2018
Brucellosis is an infection caused by several types of bacteria of the genus Brucella. The disease is transmitted from animals to humans, more often with unpasteurized milk, cheese and other dairy products.
Although the disease is not widespread in developed countries in Europe and the United States, it affects hundreds of thousands of people worldwide. For example, if the United States annually registers no more than 200 cases, then worldwide the incidence is 500,000 cases annually.
As a separate disease, brucellosis in humans has a minimal occurrence in EU member states. Only a few confirmed cases are recorded annually in these states, mainly among tourists from endemic regions or among immigrants. The maximum incidence among European countries is recorded in Spain.
Eastern European countries are not included in the brucellosis risk group. In Poland, rare cases of morbidity are observed only in veterinarians and in visitors from the Mediterranean countries. In Russia, an increased incidence of brucellosis is present only in the Caucasus. For example, in Dagestan, 100 cases per 1 million people are registered.
The region with the highest incidence is the Middle East. This zone contains five of the ten countries with the highest incidence of brucellosis. The country with the highest incidence rates worldwide is Syria (more than 15,000 cases annually). Potentially dangerous countries should also include Iran, Saudi Arabia, Mongolia, Kyrgyzstan, Armenia, Georgia, Uzbekistan and Turkmenistan.
How can you get sick?
Brucellosis in humans develops after contact with an animal (cows, pigs, sheep, goats, less often horses, camels, etc.) or an animal product infected with the bacterium Brucella. Very rarely, the bacteria can also be transmitted from person to person, including through sexual contact.
In a sick animal, the release of the pathogen occurs:
- with milk
- with amniotic fluid
- with feces (urine, feces)
The entry of the pathogen into the human body occurs:
- Fecal-oral route, that is, through food and liquid contaminated with bacteria (especially unpasteurized milk, koumiss, feta cheese, cheeses or raw meat)
- In the production of products from the skin and wool of animals (when processing animal raw materials)
- Cuts and scratches on the skin, that is, through microtraumas on the mucous membranes and skin when caring for animals
- Respiratory tract (when inhaling bacteria with air)
- Animals with their feces pollute water, land, food - exposing a person to the risk of contracting brucellosis in a non-food way.
People have a high susceptibility to brucellosis, after the transfer of infection for 6-9 months, immunity is maintained. Re-infection with Brucella occurs in 2-7% of cases. Usually the disease is caused by one of 4 main types of pathogens:
- Brucella melitensis. Most cases of brucellosis are in humans. The source is sheep and goats. Distributed in Spain, Greece, Latin America, the Middle East and India.
- Brucella Suis. The most common causative agent of brucellosis in the United States. The source is wild pigs.
- Brucella canis. The source of infection is usually dogs. Distributed in North, Central and South America, Japan and central Europe.
- Brucella abortus. The source of infection is cattle. Distributed everywhere. This species, as the primary causative agent of the disease, was completely destroyed in several European countries, Japan, Israel, Canada, Australia and New Zealand.
Can you get infected from your dog?
Dogs can become carriers of B. canis. There are several confirmed cases where the symptoms of brucellosis characteristic of the disease developed in owners of infected dogs, but the course of the disease in these cases was not severe and patients were quickly cured without serious consequences.
It is very difficult to get brucellosis from a dog, since the main route of infection is food. The only exception are veterinarians who are constantly in contact with animal biological fluids (blood, saliva).
Risk factors
In the US, brucellosis is more common in men. Usually these are people who work or once worked in the field of animal husbandry. The disease is rare in children.
Risk factors for developing brucellosis include:
- Eating unpasteurized dairy products, including cheeses called "country cheeses", especially those brought from endemic regions (Mediterranean)
- Travel or business trips to high incidence areas
- Working in a meatpacking plant or slaughterhouse
- Work in agriculture, life in the countryside
Also at increased risk are veterinarians working with brucellosis vaccines and hunters.
Symptoms of the disease
At an early stage, brucellosis in a person, whose symptoms are very similar to influenza or other viral infections, is very difficult to diagnose. The initial manifestations of brucellosis include:
- Temperature increase with high "candles" in the daytime and evening (the most common sign of brucellosis)
- Back pain, pain or burning in the limbs
- Poor appetite and weight loss
- Headache, night sweats, weakness
After penetration into the body of the pathogen that causes brucellosis, symptoms in humans appear after 5-30 days (on average, 2-3 weeks), with latent carriage it can be extended up to 3 months. The severity of the course depends on the type of pathogen:
- B. abortus causes mild manifestations. The patient's condition is regarded as mild or moderate, but the disease often takes on a chronic character.
- Symptoms of B. canis disease may be transient. The course is similar to B. abortus infection, but vomiting and diarrhea are more common.
- B. suis can cause abscess formation in various organs.
- B. melitensis causes a severe course with sudden onset. Such a disease can lead to disability of the patient.
Protracted (chronic) course of brucellosis is manifested by constant, increasing weakness, apathy, pain in the joints. This character has a less favorable prognosis and can lead to underestimation of the condition and late seeking medical help. According to statistics, a chronic course is several times more likely to end in disability of patients.
Acute brucellosis
In young and middle-aged people it develops rapidly, in older people it usually develops gradually:
- general malaise, feeling overwhelmed, loss of appetite
- insomnia (see), emotional lability
- muscle and joint pain
- and so for several days, then the temperature rises sharply for no apparent reason
- chills alternate with
- febrile and intoxication period lasts up to 3-4 weeks
- at the peak of fever - general blanching of the skin, but redness and swelling of the face
- all patients have an increase in the liver, spleen, regional lymph nodes (mainly axillary and cervical, which are moderately painful when palpated).
Subacute form
- A feverish state alternates with periods of normal or subfebrile body temperature, at high temperatures, bradycardia may occur (a discrepancy between the heart rate and body temperature), weakness, goosebumps in various parts of the body, pain in muscles and joints. At normal temperatures, patients experience thirst, constipation, increased heart rate.
- Dense formations appear, the size of a pea or a chicken egg along the muscles and tendons, the so-called fibrositis and cellulitis.
- There are signs of allergic reactions - vascular disorders, dermatitis, rash.
- The patient's joints also suffer - bursitis, polyarthritis, tendovaginitis.
- In men, brucellosis can affect the testicles and their appendages; in women, endometritis and menstrual irregularities occur; during pregnancy, it can cause premature birth or miscarriage.
- With a severe course of the infection, there is a risk of developing an infectious-toxic shock, which is complicated by pericarditis - inflammation of the membranes of the heart.
Chronic brucellosis
- The duration of the disease increases with repeated infection and reaches 2-3 years
- With this form, the temperature is rarely higher than subfebrile, relapses occur after 1-2 months, with the addition of another infection or virus (flu, cold, etc.), the condition worsens significantly.
- Symptoms depend on which functional system of the body is more affected. If the joints, then they often undergo deformation and destruction, if the spine, then spondylitis develops, limiting the patient's movements and causing severe pain. Fibrosis and cellulitis develop in the elbow joints and in the area of the sacrum and lower back.
- Neuritis often develops, such as auditory or sciatica, paresthesia, inflammation of the nerve plexuses, and even reactive neurosis.
- There are fertility disorders - impotence in men (see), infertility in women, allergic inflammation of the sex glands.
- The long course of the disease leads to irreversible changes in the joints and ligaments - muscle atrophy, spondylosis, ankylosis, which requires surgical intervention.
Residual brucellosis is the so-called delayed consequences of infection, when pathological reactivity is formed in the body. There is an immunological restructuring, which is accompanied by pathology of the joints, subfebrile temperature, and psychological changes.
Treatment
The main goal of treating brucellosis is to control symptoms and prevent them from getting worse. The main principle of therapy is multicomponent antibacterial treatment, since in most cases there was no effect from the use of any one antibiotic.
Antibiotics
Although many antibiotics show high activity against Brucella in the laboratory, only a few drugs are really effective when used in medical practice:
- Doxycycline
- Gentamicin
- Streptomycin
- Rifampicin
- Trimethoprim-sulfamethoxazole
Treatment of brucellosis with a mild course of the disease can be started with the use of one antibiotic - doxycycline tablets 100 mg twice a day for 6 weeks. However, in this case, there is often no effect (40% of cases), so rifampicin is added to the treatment at a dosage of 600-900 mg / day. In regions with an increased frequency of pathogen resistance to rifampicin, it is preferable to use other combinations described below.
- Doxycycline 100 mg 2 raa a day + Rifampicin 600-900 mg / day. Both drugs are taken for 6 weeks;
- Doxycycline 100 mg 2 times a day for 6 weeks + Streptomycin 1 g/day intramuscularly for 2-3 weeks. This scheme is considered to be more effective, especially in preventing the development of pathogen resistance. Gentamicin can be used as a substitute for streptomycin.
The treatment of choice for brucellosis in children under 8 years of age is a combination of rifampicin and trimethoprim. The frequency of development of resistance in such cases is no more than 5%. In pregnant women, it is recommended to use rifampicin, either alone or in combination with trimethoprim. It should be borne in mind that the use of trimethoprim in the third trimester of pregnancy is associated with a high incidence of kernicterus in a child.
Patients with endocarditis require aggressive antibiotic therapy. For this, a combination of doxycycline + rifampicin + trimethoprim is used for 4 weeks, enhanced by the additional administration of aminoglycosides in the next 8 to 12 weeks.
Chronic brucellosis is treated with a combination of three antibiotics: rifampicin, doxycycline and streptomycin.
Corticosteroids
The use of corticosteroids is justified in brucellosis meningitis. Although their appointment is recommended by most experts, statistics show that often corticosteroids in such cases are not prescribed at all. There is no consensus on dosing regimens, indications for prescribing and duration of treatment with these drugs.
Depending on the severity of other symptoms, patients are prescribed analgesics, anti-inflammatory and other drugs.
The recovery period takes several weeks or even months. The prognosis of treatment is positive if the use of antibiotics was started within a month from the onset of the first symptoms.
Surgical treatment of brucellosis is carried out only with the development of complications (endocarditis - restoration of the heart valves, opening and drainage of abscesses in the joints and spine). Typically, treatment for endocarditis involves replacing the affected valve with an artificial one.
Complications
Brucellosis can affect almost any part of the patient's body, including the organs of the reproductive system, liver, heart, and central nervous system. Possible complications include:
- Endocarditis. This is one of the most serious conditions that can lead to malfunction of the heart valves. Endocarditis is the main cause of death in patients with brucellosis;
- Arthritis. Infectious joint inflammation is characterized by pain, stiffness, and swelling in the affected area (usually in the knees, ankles, hips, wrists, and spine);
- Infectious inflammation of the testicles (epididymo-orchitis). Brucella can invade the epididymis, the tube that connects the vas deferens and the testicles. From there, the infection can spread further into the testicles, causing swelling and pain;
- Infectious inflammation of the liver and spleen. With the development of this complication, the patient has an increase in these organs in size and pain appears in the epigastric region;
- Central nervous system infections: meningitis (inflammation of the membranes surrounding the brain) and encephalitis (actual inflammation of the brain).
Brucellosis in pregnant women can cause miscarriage, fetal abnormalities.
Death from brucellosis is rare. Most of them are the result of a malfunction of the heart after the development of endocarditis.
Prevention
There is no specific effective vaccine against brucellosis for humans. The main recommendations for preventing infection are:
- Avoid consumption of unpasteurized dairy products;
- Compliance with hygiene rules and wearing gloves by agricultural workers;
- Vaccination of pets. Thanks to the mass vaccination of livestock, the problem of brucellosis in the United States has been almost completely eliminated.
Since vaccination is carried out with live weakened bacteria, getting the vaccine into the human body can cause disease.
After contact with an animal infected with Brucella bacteria, even in the absence of symptoms, close monitoring of the patient's condition is necessary for 6 months.
Brucellosis is a disease that can occur in adults, but it is believed that the disease is Gibraltar fever, which is inherent in animals. However, it is worth noting that it can be transmitted from animals to humans. Brucellosis in humans is characterized by an acute course, it can cause some complications and disorders in the work of the cardiovascular, nervous, reproductive systems of a person, as well as disrupt the functioning of the musculoskeletal system.
The name of this disease comes from the name of the first scientist who discovered the brucellosis virus, this happened back in 1886. This disease is characterized by the fact that 3 types of microorganisms can cause it - these are:
- those that infect cattle;
- those that infect small cattle;
- those that can be found in the body of wild animals such as hares, deer, pigs and so on.
First, we need to define what brucellosis is.
So, brucellosis is an infectious disease that, when affected, can cause disruption in the functioning of vital human systems. This is musculoskeletal, and cardiovascular and others.
Methods and sources of infection transmission
Brucellosis can be contracted mainly in three ways, which are easy to identify:
- Infection can occur in a domestic way if a person has lesions on the skin or mucous membranes that are in direct contact with the infected.
- The second - the most common way of transmitting this virus - is fecal-oral, can be explained by the example of when a person eats food contaminated with this virus, it can be cheese, milk or meat of a sick animal.
- It is also possible to become infected by airborne droplets if you come into contact with a sick person.
The causative agent of the disease is the brucella virus, the source of which is animals, these microbes are found in their urine, blood, feces, when in contact with them, a person is at risk of becoming infected, especially if he has injuries on his body through which infection actually occurs.
Note that a person who is a carrier of this virus is not dangerous to other people, since he cannot become a source of the virus for them.
The virus can enter the human body not only through contact with a sick animal, but also in cases where foods obtained from infected livestock are eaten.
If the causative agent of brucellosis has already entered the body, then it spreads rapidly throughout all systems.
Features of the course of the disease
When it enters the human body, the virus stays for one to four weeks and does not cause much harm and does not show any signs of presence. This disease is also characterized by the fact that it is definitely impossible to immediately determine from the symptoms that it is brucellosis that is taking place. Therefore, experts distinguish several types of the course of the disease, each of which has symptoms and other features, for example, the duration of the disease:
- The acute form of this pathology lasts up to one and a half months.
- Subacute, the duration of which is already up to four months.
- The chronic stage has a duration of more than four months.
- A special case is the development of the residual stage of this pathology.
![](https://i2.wp.com/infekc.ru/wp-content/uploads/2014/10/xkorova-kupno-ragatui-skot.png.pagespeed.ic.ZSpZ-N7OoT.jpg)
Brucillosis of cattle is a disease that is inherent in cattle. Infection of livestock occurs through contact with a sick animal. The most common lesions in animals are those of the reproductive system, it is also important to note that fatal cases are very rare.
In livestock farms, they usually know what to do when situations of animal infection with brucellosis arise, sometimes sick animals are isolated from the herd, so it is very important for every cattle breeder to know what brucellosis is.
Symptoms of brucellosis in humans
In humans, the symptoms of the disease have differences that can be divided into subgroups according to the type of course of the disease, that is, depending on the stage, which we considered a little earlier.
- If we talk about the acute form of the course of the disease, then it is characterized by the following symptoms:
- Lack of appetite.
- Headache.
- Insomnia.
- Body temperature can rise up to 40 degrees.
- Common symptoms include weakness, chills, irritability, and muscle pain.
- Next, consider the symptoms that are observed in the subacute form of the course of the disease. With this form of the disease, one can observe sudden changes in body temperature, a feeling of constant thirst, but the appetite is either very poor or absent at all, and a feeling of pain in the muscles, bones and joints is also characteristic. As well as in the acute form, insomnia, irritability, chills and other symptoms are observed.
- The chronic form of brucellosis is characterized by more serious complications that relate to the nervous system, the musculoskeletal system, and the human reproductive system. Various hormonal disruptions and other pathologies can be observed.
- Residual brucellosis is characterized by the fact that changes in the body occur more seriously, this applies to the central and autonomic nervous system.
It is recommended to start treatment of this disease at the initial stage of its development, thus it is possible to avoid some consequences dangerous for human health and life.
Diagnosis of a disease such as brucellosis occurs only after the patient visits a doctor, after consultation and passing some tests, we can say that it is brucellosis that occurs.
After the specialist has diagnosed brucellosis, it is necessary to begin treatment immediately.
Treatment
The first thing to note is that all methods of treatment involve the immediate hospitalization of the patient in a hospital. Treatment is carried out strictly under medical supervision. An analysis for brucellosis involves the passage of some diagnostic methods, these are blood and cerebrospinal fluid tests and other diagnostic methods.
The first appointment of a specialist doctor will be the passage of bacterial therapy. Rifampicin and doxycycline will need to be taken for about two weeks. Some anti-inflammatory drugs are also used at the same time as prescribed by a doctor.
In order to maintain immunity during the treatment of brucellosis in humans, drugs are also used to increase the body's defenses.
All doctor's appointments largely depend on the form of the course of the brucellosis disease and the characteristics of the human body itself.
If the disease takes a chronic form, then treatment methods such as UHF and paraffin applications are used. This method of treatment may involve the patient being in a spa treatment.
In order to avoid or somehow reduce the risk of contracting this disease, it is recommended to follow some preventive measures.
Prevention
If there are risks of contracting this disease, then in a situation where some signs of brucellosis occur, you should immediately contact a specialist. All preventive measures can be aimed at preventing contact with sick animals, if this is not possible, then it is imperative to take measures to prevent animal disease.
Forecasts
If we talk about timely treatment, it is important to note that the patient is much more likely to return to a healthy life without pathologies. However, if treatment is not started in a timely manner at the initial stage, then the risk of becoming disabled increases several times, since the disease can take a chronic form. If a woman in position is exposed to the disease, then pregnancy will not have positive aspects, since there is a spontaneous abortion, stillbirth, or premature birth. Getting sick with brucellosis during pregnancy is very dangerous for both the woman herself and her unborn baby.