Brucellosis
| Brucellosis (undulant fever) presents with
FLI and fever of variable duration, headache, sweats, arthralgia,
and weakness.
Osteoarticular (sacroiliitis) complications in 20-60%. Genitourinary (orchitis and epididymitis) complications in 2-20%. |
| Incubation Period: 5-60 days |
| Natural risk to humans is from untreated milk and milk products, meat processing, and livestock handling. |
| Case Fatality Rate is about 2 % (endocarditis) |
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A likely subject |
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Isolation |
| No special precautions are required. Healthcare workers use Standard Precautions. |
|
Quarantine |
| Quarantine of case contacts not required. |
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Treatment |
| Doxycycline 100mg po bid for 6 weeks
Plus Gentamicin for 2-3 weeks OR Streptomycin 1gm IM qd for 2-3 weeks OR Rifampin 600-900mg qd for 6 weeks OR TMP/SMX DS one tablet qid for 6 weeeks |
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Pediatric |
| TMP/SMX 5mg/kg of TMP q12h po for 6 weeks PLUS Gentamicin 2gm/kg q8h iv/im for 2 weeks |
| Relapse rate may be 6-14% and as high as 25% if a fluoroquinolone is used. |
| A CT scan with brucelloma in the spleen showing the typical calcified target appearance in this patient surrounded by an area of reactivation |