Brucellosis natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
The disease's [[wiktionary:sequela|sequelae]] are highly variable and may include [[hepatitis|granulomatous hepatitis]], [[arthritis]], sacroilitis, [[meningitis]], orchitis, epididymitis  [[uveitis]], and [[endocarditis]].<ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 3, 2016</ref><ref name="abc">FAO/WHO/OIE Brucellosis in humans and animals. WHO (2006). http://www.who.int/csr/resources/publications/Brucellosis.pdf Accessed on February 3, 2016  </ref> The prognosis of brucellosis is good with treatment. Relapse may occur, and symptoms may continue for years. As with tuberculosis, the illness can come back after a long period of time.<ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 1, 2016</ref><ref name="f">Brucellosis. Medline Plus. https://www.nlm.nih.gov/medlineplus/ency/article/000597.htm. Accessed on February 3, 2016</ref>
Common complications of brucellosis include [[hepatitis|granulomatous hepatitis]], [[arthritis]], sacroilitis, [[meningitis]], orchitis, epididymitis  [[uveitis]], and [[endocarditis]].<ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 3, 2016</ref><ref name="abc">FAO/WHO/OIE Brucellosis in humans and animals. WHO (2006). http://www.who.int/csr/resources/publications/Brucellosis.pdf Accessed on February 3, 2016  </ref> The prognosis of brucellosis is good with treatment. Relapse may occur, and symptoms may continue for years. As with tuberculosis, the illness can come back after a long period of time.<ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 1, 2016</ref><ref name="f">Brucellosis. Medline Plus. https://www.nlm.nih.gov/medlineplus/ency/article/000597.htm. Accessed on February 3, 2016</ref>


==Natural History==
==Natural History==

Revision as of 16:08, 3 February 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Danitza Lukac

Overview

Common complications of brucellosis include granulomatous hepatitis, arthritis, sacroilitis, meningitis, orchitis, epididymitis uveitis, and endocarditis.[1][2] The prognosis of brucellosis is good with treatment. Relapse may occur, and symptoms may continue for years. As with tuberculosis, the illness can come back after a long period of time.[1][3]

Natural History

Complications

  • Osteoarticular:
    • Bone and joint involvement
      • Most frequent complications
      • The occur in approximately 40% of cases.
    • Syndromes reported:
      • Sacroiliitis
        • Most common
      • Bursitis
      • Peripheral arthritis
      • Osteomyelitis
      • Tenosynovitis
      • Spondylitis
  • Cardiovascular:
    • Infective endocarditis
      • Common cardiovascular complication
      • Frequent cause of death
      • It has been reported in approximately 2% of cases
      • The aortic valve is more commonly affected than the mitral valve
      • Valve replacement surgery is usually needed apart from the medical therapy
    • Sinus of Valsalva aneurysm
      • Common complication when infection is due to B. suis
  • Hepatobiliary complications:
    • Granulomatous hepatitis
      • Due to B. abortus
    • Post-necrotic cirrhosis
      • Very rare
    • Chronic suppurative lesions and hepatic abscesses
      • Due to B. suis
  • Genitourinary:
    • Orchitis and epididymitis
      • Frequent genioutinary complications within men
  • Neurological:
    • Meningitis or meningoencephalitis
      • Most common frequent complications of neurobrucellosis
    • Brain and epidural abscesses
    • Cerebellar ataxia
    • Cerebral vasculitis
    • Guillain-Barré syndrome
    • Haemorrhage
    • Mycotic aneurysms
    • Stroke
    • Neuropathy/radiculopathy
    • Poliomyelitis-like syndrome
  • Gastrointestinal:
    • Colitis,ileitis, and spontaneous bacterial peritonitis.
      • Rare cases have been reported.
  • Respiratory tract:
    • Bronchopneumonia
    • Empyema
    • Hilar and paratracheal lymphadenopathy
    • Interstitial pneumonitis
    • Lung nodules
    • Pleural effusions
  • Pregnancy:
    • Spontaneous abortion
  • Cutaneous:
    • Erythema nodosum
    • Nodules
    • Papules
    • Petechiae
    • Purpura
    • Rashes
    • Abscesses, cutaneous ulcers, and suppurative lymphangitis
      • Common complication when infection is due to B. suis
  • Opthalmic:
    • Uveitis
      • Most frequent ophtalmic complications[2]

Prognosis

  • The mortality of the disease in 1909, as recorded in the British Army and Navy stationed in Malta, was 2%.
  • The most frequent cause of death was endocarditis.
    • Recent advances in antibiotics and surgery have been successful in preventing death due to endocarditis.
  • Relapse may occur, and symptoms may continue for years. As with tuberculosis, the illness can come back after a long period of time.[1][3]

Reference

  1. 1.0 1.1 1.2 Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 3, 2016
  2. 2.0 2.1 FAO/WHO/OIE Brucellosis in humans and animals. WHO (2006). http://www.who.int/csr/resources/publications/Brucellosis.pdf Accessed on February 3, 2016
  3. 3.0 3.1 Brucellosis. Medline Plus. https://www.nlm.nih.gov/medlineplus/ency/article/000597.htm. Accessed on February 3, 2016

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