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Clinical Microbiology Reviews Dec 2019The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patient's proper... (Review)
Review
The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patient's proper treatment. The diagnosis of brucellar infections can be made by culture, serological tests, and nucleic acid amplification assays. Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases. Serological tests, though they lack specificity and provide results that may be difficult to interpret in individuals repeatedly exposed to organisms, nevertheless remain a diagnostic cornerstone in resource-poor countries. Nucleic acid amplification assays combine exquisite sensitivity, specificity, and safety and enable rapid diagnosis of the disease. However, long-term persistence of positive molecular test results in patients that have apparently fully recovered is common and has unclear clinical significance and therapeutic implications. Therefore, as long as there are no sufficiently validated commercial tests or studies that demonstrate an adequate interlaboratory reproducibility of the different homemade PCR assays, cultures and serological methods will remain the primary tools for the diagnosis and posttherapeutic follow-up of human brucellosis.
Topics: Brucella; Brucellosis; Clinical Laboratory Techniques; Humans; Molecular Diagnostic Techniques; Nucleic Acid Amplification Techniques; Serologic Tests
PubMed: 31722888
DOI: 10.1128/CMR.00073-19 -
The Veterinary Quarterly Jan 2021Brucellosis is a zoonotic disease of great animal welfare and economic implications worldwide known since ancient times. The emergence of brucellosis in new areas as... (Review)
Review
Brucellosis is a zoonotic disease of great animal welfare and economic implications worldwide known since ancient times. The emergence of brucellosis in new areas as well as transmission of brucellosis from wild and domestic animals is of great significance in terms of new epidemiological dimensions. Brucellosis poses a major public health threat by the consumption of non-pasteurized milk and milk products produced by unhygienic dairy farms in endemic areas. Regular and meticulous surveillance is essentially required to determine the true picture of brucellosis especially in areas with continuous high prevalence. Additionally, international migration of humans, animals and trade of animal products has created a challenge for disease spread and diagnosis in non-endemic areas. Isolation and identification remain the gold standard test, which requires expertise. The advancement in diagnostic strategies coupled with screening of newly introduced animals is warranted to control the disease. Of note, the diagnostic value of miRNAs for appropriate detection of infection has been shown. The most widely used vaccine strains to protect against infection and related abortions in cattle are strain 19 and RB51. Moreover, it is very important to note that no vaccine, which is highly protective, safe and effective is available either for bovines or human beings. Research results encourage the use of bacteriophage lysates in treatment of bovine brucellosis. One Health approach can aid in control of this disease, both in animals and man.
Topics: Animals; Bacterial Vaccines; Brucella; Brucellosis, Bovine; Cattle; Humans; MicroRNAs; Zoonoses
PubMed: 33353489
DOI: 10.1080/01652176.2020.1868616 -
Annals of Medicine 2023Brucellosis is a pervasive zoonotic disease caused by various species. It mainly affects livestock and wildlife and poses significant public health threats, especially... (Review)
Review
Brucellosis is a pervasive zoonotic disease caused by various species. It mainly affects livestock and wildlife and poses significant public health threats, especially in regions with suboptimal hygiene, food safety, and veterinary care standards. Human contractions occur by consuming contaminated animal products or interacting with infected animals. This study aims to provide an updated understanding of brucellosis, from its epidemiology and pathogenesis to diagnosis and treatment strategies. It emphasizes the importance of ongoing research, knowledge exchange, and interdisciplinary collaboration for effective disease control and prevention, highlighting its global health implications. Pathogenesis involves intricate interactions between bacteria and the host immune system, resulting in chronic infections characterized by diverse clinical manifestations. The diagnostic process is arduous owing to non-specific symptomatology and sampling challenges, necessitating a fusion of clinical and laboratory evaluations, including blood cultures, serological assays, and molecular methods. Management typically entails multiple antibiotics, although the rise in antibiotic-resistant strains poses a problem. Animal vaccination is a potential strategy to curb the spread of infection, particularly within livestock populations. The study provides insights into the complex pathogenesis of brucellosis, the challenges in its diagnosis, and the management strategies involving antibiotic therapy and animal vaccination. It also highlights the emerging issue of antibiotic-resistant strains. In conclusion, brucellosis is a significant zoonotic disease with implications for public health. Efforts should be directed towards improved diagnostic methods, antibiotic stewardship to combat antibiotic resistance, and developing and implementing effective animal vaccination programs. Interdisciplinary collaboration and ongoing research are crucial for addressing the global health implications of brucellosis.
Topics: Animals; Humans; Brucellosis; Zoonoses; Brucella; Animals, Wild; Livestock; Anti-Bacterial Agents
PubMed: 38165919
DOI: 10.1080/07853890.2023.2295398 -
Frontiers in Cellular and Infection... 2023rucellosis is a common zoonotic disease that is widely spread worldwide and poses a major threat to human health. Clinically, it often presents with non-specific... (Review)
Review
rucellosis is a common zoonotic disease that is widely spread worldwide and poses a major threat to human health. Clinically, it often presents with non-specific symptoms such as fever, excessive sweating, malaise, myalgia, arthralgia, loss of appetite, weight loss, and enlarged liver, spleen and lymph nodes. The disease has a long and recurrent course, often accumulating in multiple systems and organs. Of these, osteoarticular involvement is the most common complication, with a prevalence of approximately 2-77%, usually manifesting as spondylitis, sacroiliac arthritis and peripheral arthritis. Hepatosplenomegaly is seen in about 50% of patients with rucellosis, and gastrointestinal disturbances such as abdominal pain, nausea, and vomiting are common. Although respiratory involvement is less common, pneumonia, pleurisy, pleural effusion, and pulmonary nodules have been reported. Besides, approximately 2-20% of cases involve infections of the male genitourinary system, mainly manifesting as unilateral epididymal-orchitis and orchitis. The most serious complication facing rucellosis is cardiovascular involvement, and although the overall mortality rate of rucellosis is about 1% and the incidence of rucellosis endocarditis is less than 2%, more than 80% of deaths are associated with endocarditis. Furthermore, rucellosis is complicated by hematologic disease, with anemia occurring in approximately 20-53% of children during the acute phase. In addition, the neurological incidence of rucellosis is about 0.5-25%, mainly manifested as meningitis. In this study, we review the multisystem complications of brucellosis with the aim of improving early diagnosis, timely treatment and prevention of long-term complications.
Topics: Child; Humans; Male; Orchitis; Brucellosis; Pleural Effusion; Spondylarthritis; Endocarditis
PubMed: 37065189
DOI: 10.3389/fcimb.2023.1136674 -
The American Journal of Pathology Jun 2015This review of Brucella-host interactions and immunobiology discusses recent discoveries as the basis for pathogenesis-informed rationales to prevent or treat... (Review)
Review
This review of Brucella-host interactions and immunobiology discusses recent discoveries as the basis for pathogenesis-informed rationales to prevent or treat brucellosis. Brucella spp., as animal pathogens, cause human brucellosis, a zoonosis that results in worldwide economic losses, human morbidity, and poverty. Although Brucella spp. infect humans as an incidental host, 500,000 new human infections occur annually, and no patient-friendly treatments or approved human vaccines are reported. Brucellae display strong tissue tropism for lymphoreticular and reproductive systems with an intracellular lifestyle that limits exposure to innate and adaptive immune responses, sequesters the organism from the effects of antibiotics, and drives clinical disease manifestations and pathology. Stealthy brucellae exploit strategies to establish infection, including i) evasion of intracellular destruction by restricting fusion of type IV secretion system-dependent Brucella-containing vacuoles with lysosomal compartments, ii) inhibition of apoptosis of infected mononuclear cells, and iii) prevention of dendritic cell maturation, antigen presentation, and activation of naive T cells, pathogenesis lessons that may be informative for other intracellular pathogens. Data sets of next-generation sequences of Brucella and host time-series global expression fused with proteomics and metabolomics data from in vitro and in vivo experiments now inform interactive cellular pathways and gene regulatory networks enabling full-scale systems biology analysis. The newly identified effector proteins of Brucella may represent targets for improved, safer brucellosis vaccines and therapeutics.
Topics: Animals; Brucella; Brucellosis; Host-Pathogen Interactions; Humans
PubMed: 25892682
DOI: 10.1016/j.ajpath.2015.03.003 -
BioMed Research International 2018. Brucellosis has a wide spectrum of clinical manifestations and it may last several days or even several years; however, it is often misdiagnosed and therefore may... (Meta-Analysis)
Meta-Analysis Review
. Brucellosis has a wide spectrum of clinical manifestations and it may last several days or even several years; however, it is often misdiagnosed and therefore may cause inadequate therapy and prolonged illness. Previous studies about meta-analysis of manifestations of brucellosis reported in English lacked the data published in Chinese, which did not provide details about the contact history, laboratory tests, and misdiagnosis. We undertake a meta-analysis of clinical manifestations of human brucellosis in China to identify those gaps in the literature. We have searched published articles in electronic databases up to December 2016 identified as relating to clinical features of human brucellosis in China. 68 studies were included in the analysis. The main clinical manifestations were fever, fatigue, arthralgia, and muscle pain (87%, 63%, 62%, and 56%, resp.). There are significant differences between adults and children. Rash, respiratory and cardiac complications, and orchitis/epididymitis were more prevalent in children patients. The common complications of brucellosis were hepatitis, followed by osteoarthritis, respiratory diseases, cardiovascular diseases, central nervous system dysfunction, hemophagocytic syndrome, and orchitis/epididymitis in male. In the nonpastoral areas, brucellosis has a high ratio of misdiagnosis. Our analysis provides further evidence for the accurate diagnosis, particularly in assessing severe, debilitating sequelae of this infection.
Topics: Adult; Brucellosis; Child, Preschool; China; Diagnostic Errors; Geography; Humans; Incidence
PubMed: 29850535
DOI: 10.1155/2018/5712920 -
International Journal of Molecular... Apr 2021Brucellosis is a highly prevalent zoonotic disease characterized by abortion and reproductive dysfunction in pregnant animals. Although the mortality rate of Brucellosis... (Review)
Review
Brucellosis is a highly prevalent zoonotic disease characterized by abortion and reproductive dysfunction in pregnant animals. Although the mortality rate of Brucellosis is low, it is harmful to human health, and also seriously affects the development of animal husbandry, tourism and international trade. Brucellosis is caused by , which is a facultative intracellular parasitic bacteria. It mainly forms -containing vacuoles (BCV) in the host cell to avoid the combination with lysosome (Lys), so as to avoid the elimination of it by the host immune system. not only has the ability to resist the phagocytic bactericidal effect, but also can make the host cells form a microenvironment which is conducive to its survival, reproduction and replication, and survive in the host cells for a long time, which eventually leads to the formation of chronic persistent infection. can proliferate and replicate in cells, evade host immune response and induce persistent infection, which are difficult problems in the treatment and prevention of Brucellosis. Therefore, the paper provides a preliminary overview of the facultative intracellular parasitic and immune escape mechanisms of , which provides a theoretical basis for the later study on the pathogenesis of .
Topics: Animals; Brucella; Brucellosis; Chronic Disease; Host-Pathogen Interactions; Humans
PubMed: 33916050
DOI: 10.3390/ijms22073673 -
Microbes and Infection 2018Brucellosis remains burdensome for livestock and humans worldwide. Better vaccines for protection are needed to reduce disease incidence. Immunity to brucellosis and... (Review)
Review
Brucellosis remains burdensome for livestock and humans worldwide. Better vaccines for protection are needed to reduce disease incidence. Immunity to brucellosis and barriers to protection are discussed. The benefits and limitations of conventional and experimental brucellosis vaccines are outlined, and novel vaccination strategies needed to ultimately protect against brucellosis are introduced.
Topics: Administration, Mucosal; Animals; Brucella Vaccine; Brucellosis; Humans; Immunity, Cellular; Vaccination
PubMed: 29287984
DOI: 10.1016/j.micinf.2017.12.006 -
Tuberkuloz Ve Toraks Mar 2020Brucellosis is widely distributed zoonotic infection. Brucellosis is a multisystemic disease but pulmonary infection due to brucellosis is very rarely reported. (Review)
Review
INTRODUCTION
Brucellosis is widely distributed zoonotic infection. Brucellosis is a multisystemic disease but pulmonary infection due to brucellosis is very rarely reported.
MATERIALS AND METHODS
We retrospectively evaluated our pediatric brucellosis cases between February 2014 and December 2015. The brucellosis patients with and without pulmonary infection were compared with each other.
RESULT
We detected pulmonary infection in 18 of the 98 brucellosis patients. There was no statistical significant difference between the brucellosis patients with and without a pulmonary infection as regards age, gender, and animal husbandry history. The laboratory findings including the Brucella Coombs agglutination titers were also similar. The most common chest X-ray findings were interstitial infiltration and hilar lymphadenopathy. All of our cases with pulmonary infection recovered with the usual anti-brucella treatment.
CONCLUSIONS
Brucellosis may cause a pulmonary infection more often than thought. The prognosis of respiratory brucellosis is good and the classic treatment regimen is appropriate.
Topics: Animals; Brucella; Brucellosis; Child; Coombs Test; Female; Humans; Lung Diseases, Interstitial; Male; Respiratory Tract Infections; Retrospective Studies
PubMed: 32718139
DOI: 10.5578/tt.69015 -
Emerging Microbes & Infections Dec 2023The zoonotic bacteria, , is becoming the leading cause of canine brucellosis in Europe. In dogs, it causes reproductive problems as well as non-specific lameness or... (Review)
Review
The zoonotic bacteria, , is becoming the leading cause of canine brucellosis in Europe. In dogs, it causes reproductive problems as well as non-specific lameness or discospondilitis. In humans, can be origin of chronic debilitating conditions characteristic to its genus such as undulant fever, splenomegaly, and lymphadenopathy. Although shows some pathogenic characteristics similar to and , it lacks surface O-polysaccharide, like nonzoonotic . This review shows that host- interactions are still poorly understood, with many knowledge and capability gaps, causing relatively poor sensitivity and specificity of existing diagnostic tools. Currently, there is no vaccine for this rough species. Besides, antimicrobial therapy does not guarantee bacterial elimination, and infection relapses are frequently reported, increasing the risks of antibiotic resistance development. has been detected in dogs in almost all European countries which increased human exposure, but currently there is no systematic surveillance. Moreover, caused brucellosis is not included in Animal Health Law, and therefore there is no legal framework to tackle this emerging infectious disease. To map out the diagnostic strategies, identify risks for human infections and propose management scheme for infected pet and kennel dogs, we present current understanding of canine caused brucellosis, outline major knowledge gaps and propose future steps. To address and highlight challenges veterinary and public health services encounter in Europe, we developed two infection scenarios: of a single household pet and of a kennel dog in larger group.
Topics: Animals; Dogs; Humans; Sheep; Brucella canis; Public Health; Dog Diseases; Brucellosis; Europe
PubMed: 37649455
DOI: 10.1080/22221751.2023.2249126