Brucelosis Diagnosis and Management

Diagnostic Considerations

The Centers for Disease Control and Prevention recommends that the ingestion of unpasteurized cheeses is the most important risk factor for brucelosis, being the primary cause of brucelosis cases in the United States 1, 2
Unpasteurized dairy products are responsible for 60% of foodborne disease outbreaks, with Brucella being one of the main pathogens 3
The American Academy of Pediatrics notes that the Rose Bengal antigen test is highly specific for Brucella and represents a screening test with excellent predictive value in the appropriate clinical context 1, 2
The Infectious Diseases Society of America states that the pattern of intermittent evening fever with chills and profuse sweating is characteristic of brucelosis 2, 4

The Infectious Diseases Society of America recommends doxycycline 100 mg every 12 hours plus rifampicin 600 mg every 24 hours for 6 weeks as the standard treatment for uncomplicated brucelosis, with a Grade AI recommendation 4
The World Health Organization notes that the combination of doxycycline and rifampicin is the most widely used treatment globally, with cure rates of 85-95% 4

The Infectious Diseases Society of America defines recurrence as the reappearance of brucelosis symptoms and signs after completing an appropriate course of antibiotic treatment, occurring in 5-15% of patients even with adequate treatment 4
Recurrence typically presents within the first 6 months after completing treatment 4
The Centers for Disease Control and Prevention recommends repeating the same doxycycline-rifampicin regimen for an additional 6 weeks if the recurrence is uncomplicated 4