Brucellosis – a systematic revision
Keywords:
Brucellosis, zoonosis, epidemiology, serologicalAbstract
Brucellosis is a zoonosis in which virtually
all human infection is related to direct or indirect contact with animal infection. The disease
in humans is caused by only four of the seven
species of the bacteria: Brucella melitensis, Brucella abortus, Brucella suis and Brucella canis.
Presently, its incidence is probably five times greater than the official figure, mostly due to
misdiagnosis of the milder forms and non-compliance with compulsory notification.
Its geographic pattern coincides with the animal endemic distribution, being mostly an occupational disease, which involves mainly the 55-64 age-group, with a male predominance.
The Brucella’ s pathogenic mechanisms are mostly due to its ability to survive in the intracellular environment, with smooth-lipopolyssacharide (LPL-S) having a fundamental role.
Brucellosis is a systemic disease. Its presentation and the duration of the clinical picture
allow for its characterization in the acute, chronic and focalized forms.
Wright’s sero-agglutination is the earliest means of serologic diagnosis in the acute form,
with ELISA being the test of choice for diagnosing neurobrucellosis, chronic brucellosis and
for follow-up of active disease. Other serologic
tests appear as alternatives. The bacteriological culture of Brucella is frequently positive if
the cultures remain in the appropriate medium
for at least four weeks.
Several treatment options are proposed, but
the association of doxicycline with streptomycin remains the most effective, with the lowest relapse rate.
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