Brucellosis Diagnosis and Treatment
Clinical Manifestations
- Fever with temperature swings is a hallmark symptom, often accompanied by profuse sweating, especially at night 1
- Headaches are frequently reported and can be severe 1
Complications
- Neurobrucellosis - can cause meningitis and other neurological complications 1
- Endocarditis - a rare but potentially fatal complication with high mortality 4
Treatment
- The Centers for Disease Control and Prevention recommends a six-week regimen of doxycycline combined with either streptomycin or rifampicin for effective treatment 1, 2
- Doxycycline 100 mg twice daily orally for 6 weeks 2
- Streptomycin 15 mg/kg daily intramuscularly for 2-3 weeks 2
- Rifampicin 600-900 mg daily as a single morning dose for 6 weeks 2
- For brucellar spondylitis, aminoglycoside-containing regimens may be superior to rifampicin-containing ones, and treatment duration may need to be extended beyond the standard 6 weeks 4, 2
- Brucellar endocarditis requires aggressive management with empirical antimicrobials and often surgical intervention 4, 2
- For brucellosis in pregnancy, TMP-SMX alone or in combination with rifampicin is recommended 4
Prevention
- Regular symptom monitoring and serologic testing for 24 weeks after exposure is recommended for high-risk individuals 1
- Avoid consumption of unpasteurized dairy products 3
- Use appropriate personal protective equipment when handling potentially infected animals 3
- Follow proper laboratory safety protocols when handling Brucella specimens 3