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Infectious Optic Neuropathies
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Imran Rizvi, Ravindra Kumar Garg
Brucellosis is caused by bacteria of Brucella species. Human brucellosis is a multisystem disease that can manifest acutely, sub acutely or in chronic course.52 Ocular involvement is not very common. The ocular manifestations of brucellosis described in the literature are keratitis, uveitis, episcleritis, scleritis, endophthalmitis and optic neuropathy.53,54 Optic nerve damage, in brucellosis, manifests with optic neuritis or papilledema. Optic nerve involvement is usually part of meningoencephalitis. The diagnosis of brucellosis requires a clinical suspicion along with microbiological confirmation. Brucellosis is treated with doxycycline and rifampicin.52 The visual prognosis of treated cases is generally good.
The locomotor system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Brucellosis is transmitted to humans from infected animals or animal products. Infection of bone and joints is more common in chronic brucellosis than in the acute form. Typically one or a few peripheral joints, especially the hip and knee, are involved. Sacroiliitis is also seen. The organism is difficult to culture but positive serological tests allow diagnosis. Histologically, the synovium or bone contains non-caseating granulomas.
Unexplained Fever In Infectious Diseases: Section 2: Commonly Encountered Aerobic, Facultative Anaerobic, And Strict Anaerobic Bacteria, Spirochetes, And Parasites
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
The laboratory should be alerted to the possibility of brucellosis; the cultures must be preserved for 4 to 6 weeks. The differential diagnosis of brucellosis is very extensive due to the polymorphism of the disease. It is most frequently confused with miliary tuberculosis, typhoid fever, rheumatic fever, malaria, amebiasis, lymphoma, and collagen-vascular diseases. In some instances, a low or false-positive agglutination test for brucellosis may lead to an erroneous diagnosis of undulant fever.
Brucellosis in older person: a case report from Qatar
Published in The Aging Male, 2022
Hanadi Khamis Al Hamad, Navas Nadukkandiyil, Mohammed Al Husami, Hebatullah Ahmed Abdelgawad, Sanjeevikumar Meenakshisundaram, Osman Bashir Nemeri
The geriatric population has been increasing worldwide, including Qatar, due to an improved standard of living. As a result of immune dysfunction caused by ageing and frailty, resistance to infections is reduced. These adverse outcomes in the elderly can mask signs and symptoms of diseases, leading to delayed diagnosis and treatment. Delayed diagnosis and treatment of brucellosis affect all body systems with various symptoms. Therefore, serious complications, which cause morbidity and mortality, can occur [4]. The clinical manifestations of brucellosis are fever, night sweating, chills, arthralgia and loss of appetite. It seems pyrexia of unknown origin without other symptoms is most common presentation of brucellosis in old age [5]. The confirmation of brucellosis can made with serological tests, with significantly high titer, in the presence or absence of blood culture. Brucella antibody titers (≥1:160) are suggestive of active infection. Brucellosis was diagnosed with a positive standard tube agglutination test or a positive blood culture [6]. Anemia and raised CRP and liver enzymes were the most prominent laboratory abnormalities in our patients. A previous study from Qatar reported that 41.7% had a history of raw milk consumption and 12.5% had a history of animal contact [7]. The objectives of brucellosis treatment include the prevention of complications and relapse [8]. Our case presented with classical symptoms, but the atypical clinical presentation can delay diagnosis and treatment, causing serious clinical disease progression with increased complications.
A systematic analysis of and recommendations for public health events involving brucellosis from 2006 to 2019 in China
Published in Annals of Medicine, 2022
Zhiguo Liu, Miao Wang, Yaxin Tian, Zhongqiu Li, Liping Gao, Zhenjun Li
Brucellosis is one of the most common zoonotic diseases globally [1]. More than 500,000 new human cases of brucellosis are reported annually, and millions of livestock are either infected or at risk [2]. It is a significant public health problem and causes serious harm to the livestock industry’s development and human health [3]. At present, at least 12 Brucella species have been identified in the genus Brucella [4]. Brucella melitensis is a pathogen of goats and sheep and is considered to be the most virulent species for humans [5]. Fever, fatigue, sweating, and muscle and joint pain are the main manifestations in the acute stage of human brucellosis [6]. However, chronic disease can affect various organs, leading to arthritis, orchitis, hepatitis, encephalomyelitis, and endocarditis [7]. Brucella spp. are highly infectious because the infectious dose by an aerosol is only 10–100 organisms [8], and it is the most important laboratory-acquired bacterial infection [9]. It is recommended that the organism is handled according to biosafety level 3 (BSL3) precautions [10]. These guidelines can be challenging to follow, particularly in regions with a low incidence of brucellosis.
Cochlear implantation in neurobrucellosis: Two case reports
Published in Acta Oto-Laryngologica Case Reports, 2022
Afrah Alshalan, Medhat Yousef, Abdulrahman Alsanosi
Brucellosis is a common zoonotic infectious disease worldwide with an annual incidence of 10-20 per100 000 subjects. Brucellosis has been enucleated in some countries; however, it is still present in Mediterranean countries and Middle East areas [1]. The diagnostic plan of brucellosis is carried out according to clinical features and laboratory investigations. This encompasses isolating the microbe from a blood sample and/or bone marrow, Wright’s serological test titer of 1:160 [2]. Associated polyneuropathy and SNHL in brucellosis raise the suspect of neurobrucellosis. However, the diagnosis is not confirmed until a CSF sample shows increased lymphocytes, high protein level, and positive standard tube-agglutination test [2]. Radiological studies may not reveal any abnormalities or may show inflammatory enhancing lesions and white matter alteration as a result of demyelination, but these findings do not correlate with presenting clinical features [5]. The management of neurobrucellosis is usually achieved through combination antibiotics including rifampicin, trimethoprim, ciprofloxacin, and doxycycline. Interventional studies reported that the treatment regimen is generally determined based on signs and symptoms of the condition and is resumed until the follow-up CSF analysis reports return normal [6].