BRUCELLOSIS - HSM

microbiology

non motile , aerobic,

Gram negative

cocco bacilli

 CULTURE- aerobic
Growth improved by liver extract

or erythritol (a sugar substitue)

classification
Br melitensis and Br abortus are 2 major groups

Br Suis (american strain)

Pathogenesis
IP 10 to 30 days Types Latent infection Acute or subacute brucellosis Chronic brucellosis

Sources Goats , sheeps ,cattle

Raw milk and other milk products and dust from wool

Laboratory diagnosis
Blood culture most specific
Large volume needed(5ml) , Subculture made on solid media on 4th day Slow growth 6 to 8 weeks , BACTEC(5 to 6 days) is preferred Castaneda method recommended BM culture standard (RES holds high conc of org)

IgM and IgG 7 to 10 days Serological tests can be done

 CBC
Usually nuetropenia Thrombocytopenia(splenomegaly or immune) Elevated liver enzymes

 Biopsy
Percutaneous liver biopsy (granulomatous hepatitis or hepatic micro abscesses)

 Symptoms & signs

Fever most common ---constitutional symptoms ---bone and joint symptoms ---GI symptoms- abd pain from dyspepsia or hepatic abcesses may occur. ---Genitourinary infections like UTI, glomerulonephritis

SIGNS
Hepatosplenomegaly Arthritis, joint effusions Epididymo orchitis is very common Endocarditis Acute meningoencephalitis(most common neurological manifestation) Papulonodular eruptions

 Pulmonary findings
CXR- hilar and paratracheal lymphadenopathy,
pulmonary nodules, pleural thickening, pleural effusion

Spinal radiographic findings

Usually appears after 2-3 weeks
Blurring of articular margins and widening of

sacroiliac spaces

Pharmacotherapy
Doxycycline Gentamicin streptomycin Rifampicin TMP-SMZ Steroids( brucella meningitis)

HSM
INFECTIONS
VIRAL-IMN,Rubella BAC-TB, leptospirosis, Brucellosis, Parasitic-malaria, toxoplasmosis Hepatic disorders o Hepatitis, cirrhosis,biliary atresia Malignancy
Leukemia, lymphoma

 Collagen disorders
SLE, RA Hemolytic anemia Cardiac failure Metabolic/ storage disorders