Brucelose – uma revisão sistematizada
Palavras-chave:
Brucelose, zoonose, epidemiologia, métodos serológicos, IFI, ELISAResumo
A brucelose é uma zoonose, derivando virtualmente todas as infecções humanas de contacto directo ou indirecto com a infecção animal.
A doença é provocada no Homem apenas por quatro das sete espécies da bactéria: Brucella
melitensis, Brucella abortus, Brucella suis e Brucella canis.
Actualmente, a sua incidência deverá ser cinco vezes superior aos números oficiais, sobretudo devido ao não diagnóstico das formas frustres e ao não cumprimento da declaração obrigatória.
A sua distribuição geográfica coincide com a endemia animal, sendo, sobretudo, uma doença ocupacional que atinge, em especial, a faixa etária dos 55-64 anos, com predomínio masculino.
Os mecanismos de patogénese da Brucella devem-se, sobretudo, à sua capacidade de sobrevivência no meio intracelular, tendo o lipopolissacárido-liso (LPL-S) um papel fundamental.
A brucelose é uma doença sistémica. A sua apresentação e duração do quadro clínico permite caracterizá-la em formas aguda, crónica e localizada.
Laboratorialmente, o teste de sero-aglutinação de Wright assume-se como o meio de diagnóstico serológico mais precoce, na forma aguda, sendo o método tipo ELISA o teste de escolha para a neurobrucelose, brucelose crónica e
para seguimento da doença activa. Outros métodos serológicos constituem alternativas. A cultura bacteriológica da Brucella é frequentemente positiva se as culturas permanecerem em
meio apropriado por pelos menos quatro semanas.
Várias alternativas terapêuticas são propostas. No entanto, a associação doxiciclina e estreptomicina permanece a mais eficaz e com menor taxa de recidiva.
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