Brucellosis - diagnosis and treatment
The diagnosis of brucellosis relies on demonstration of the agent through blood cultures, demonstration of antibodies, hepatic biopsy and radiologic alterations in infected vertebrae.
THE DIAGNOSIS of brucellosis relies on:
4.Radiologic alterations in infected vertebrae: the Pedro Pons sign (preferential erosion of antero-superior corner of lumbar vertebrae) and marked osteophytosis are suspicious of brucellic spondylitis. The disease's sequelae are highly variable and may include granulomatous hepatitis, arthritis, spondylitis, anaemia, leukopenia, thrombocytopenia, meningitis, uveitis, optic neuritis and endocarditis.
Treatment and prevention Antibiotics like tetracyclins, rifampicin and the aminoglycosides streptomycin and gentamicin are effective against Brucella bacteria. However, the use of more than one antibiotic is needed for several weeks, because the bacteria incubates within cells. The gold standard treatment for adults is daily intramuscular injections of streptomycin 1g for 14 days and oral doxycycline 100 mg twice daily for 45 days (concurrently). Gentamicin 5 mg/kg by intramuscular injection once daily for 7 days is an acceptable substitute when streptomycin is not available or difficult to obtain. Another widely used regimen is doxycycline plus rifampin twice daily for at least 6 weeks. This regimen has the advantage of oral administration. A triple therapy of doxycycline, together with rifampin and cotrimoxazole has been used successfully to treat neurobrucellosis. Doxycycline is able to cross the blood-brain barrier but requires the addition of two other drugs to prevent relapse. Ciprofloxacin and co-trimoxazole therapy is associated with an unacceptably high rate of relapse. In brucellic endocarditis, surgery is required for an optimal outcome. Even with optimal antibrucellic therapy relapses still occur in 5-10 per cent of patients with Malta fever. The main way of preventing brucellosis is by using fastidious hygiene in producing raw milk products or by pasteurisation of all milk that is to be ingested by human beings, either in its pure form or as a derivate, such as cheese. Experiments have shown that cotrimoxyzol and rifampin are both safe drugs to use in treatment of pregnant women who have Brucellosis. The disease progresses from the first liquid stool to shock in 4 to 12 hours, with death following in 18 hours to several days, unless timely oral rehydration therapy is provided.
Treatment and prevention Antibiotics like tetracyclins, rifampicin and the aminoglycosides streptomycin and gentamicin are effective against Brucella bacteria. However, the use of more than one antibiotic is needed for several weeks, because the bacteria incubates within cells. The gold standard treatment for adults is daily intramuscular injections of streptomycin 1g for 14 days and oral doxycycline 100 mg twice daily for 45 days (concurrently). Gentamicin 5 mg/kg by intramuscular injection once daily for 7 days is an acceptable substitute when streptomycin is not available or difficult to obtain. Another widely used regimen is doxycycline plus rifampin twice daily for at least 6 weeks. This regimen has the advantage of oral administration. A triple therapy of doxycycline, together with rifampin and cotrimoxazole has been used successfully to treat neurobrucellosis. Doxycycline is able to cross the blood-brain barrier but requires the addition of two other drugs to prevent relapse. Ciprofloxacin and co-trimoxazole therapy is associated with an unacceptably high rate of relapse. In brucellic endocarditis, surgery is required for an optimal outcome. Even with optimal antibrucellic therapy relapses still occur in 5-10 per cent of patients with Malta fever. The main way of preventing brucellosis is by using fastidious hygiene in producing raw milk products or by pasteurisation of all milk that is to be ingested by human beings, either in its pure form or as a derivate, such as cheese. Experiments have shown that cotrimoxyzol and rifampin are both safe drugs to use in treatment of pregnant women who have Brucellosis. The disease progresses from the first liquid stool to shock in 4 to 12 hours, with death following in 18 hours to several days, unless timely oral rehydration therapy is provided.
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.if i use gynec gloves & i should not have any skin aberration than is it possible that i suffer from brucellosis?
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