Clinical Presentations and Diagnosis of Brucellosis
Aysegul Ulu Kilic, Gokhan Metan and Emine Alp
Affiliation: Department of Infectious Disease and Microbiology, Erciyes University, Faculty of Medicine, 38039 Kayseri/Turkey.
Keywords: Brucellosis, clinical manifestations, diagnosis, patents, Malaise, arthralgia, Chronic brucellosis, Osteoarticular System, Nervous System, Tenosynovitis
Brucellosis is a worldwide zoonosis caused by Brucella species. The disease remains a significant economic
and public health problem particularly in the Mediterranean countries. Clinical manifestations of brucellosis are variable
and often nonspecific, simulating infectious and noninfectious diseases. Osteoarticular involvement is the most common
focal complication of brucellosis and morbidity. Mortality rate due to brucellosis is low, mostly secondary to endocarditis
and central nerve involvement of disease.
The diagnosis of brucellosis depends on the clinical presentations and laboratory tests. Detection of Brucella species by
culture method is sometimes unsuccessful; therefore, serological tests are preferred. These tests are easy to perform, and
results can be obtained within a short span of time. Several serologic tests have been developed for the diagnosis of human
brucellosis, including the standard agglutination tube (SAT) test, anti-human globulin (Coombs) test, indirect fluorescence
antibody (IFA) test, and enzyme-linked immunosorbent assay (ELISA). SAT is the primary test used in many
clinical laboratories. IFA and ELISA are simple and reliable for the detection of immunoglobulin classes especially in
complicated cases. Polymerase chain reaction (PCR) technique is highly sensitive and specific for the determination of
Brucella spp. from peripheral blood and other tissues.
Recent patents are especially based on molecular assays in the diagnosis of brucellosis. However, PCR is still expensive
and may not be appropriate for daily practice.
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