Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years' experience in an endemic area
| Autor: | P. L. Kariholu, Basappa G Mantur, Rajendra C. Bidri, Mallanna S. Mulimani, Siddanagouda B. Patil, Smita S. Mangalgi, M. S. Biradar, K Veerappa |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Microbiology (medical) medicine.medical_specialty Adolescent Endemic Diseases India Brucella Microbiology Brucellosis Serology Seroepidemiologic Studies Agglutination Tests Internal medicine Direct agglutination test Epidemiology Hydrocele medicine Humans Prospective Studies Mercaptoethanol biology business.industry General Medicine medicine.disease biology.organism_classification Antibodies Bacterial Surgery Agglutination (biology) business Brucella melitensis |
| Zdroj: | Journal of Medical Microbiology. 55:897-903 |
| ISSN: | 1473-5644 0022-2615 |
| DOI: | 10.1099/jmm.0.46097-0 |
| Popis: | A prospective study was carried out to elucidate the clinical, epidemiological and laboratory features of human brucellosis. A total of 26 948 blood samples (from adults aged 15 years and above) were screened for serological evidence of brucellosis over a period of 16 years. The slide agglutination/Rose Bengal plate agglutination test gave positive results in 517 patients, of which 509 had detectable titres by the standard tube agglutination test (SAT). The diagnosis of brucellosis was documented in 495 (1.8 %) patients based on diagnostic titres (⩾1 : 160, 490 cases) and rising titres from insignificant titres (four cases) by serology and for one case by blood-culture isolation alone. Blood cultures were carried out in 345 cases, of which 191 cases (55.3 %) yieldedBrucella melitensis. In 77/79 cases undertaken for follow up, there was a steady fall in 2-mercaptoethanol (2ME) agglutination titres along with clinical improvement (PBrucellaagglutinins were demonstrated in synovial, testicular, hydrocele and cerebrospinal fluids. There was no clinical suspicion of brucellosis in 439 cases (88.7 %) and the diagnosis was made only by routine serology. A two-drug regimen for 42–84 days with a follow-up 2ME test resulted in lower levels of relapse. These results suggest that, in endemic areas of the world, it should be mandatory to screen routinely for brucellosis due to protean clinical manifestations. |
| Databáze: | OpenAIRE |
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