Urinalysis Part 3

Urinalysis Part 2

Urinalysis (test strip)

Brucellosis

Definition:

Brucellosis is a serious bacterial disease that causes fever, joint pain and fatigue. Brucella, the bacteria that cause brucellosis, spread from animals to people, often via unpasteurized milk, cheese and other dairy products.

Also known as Mediterranean fever or undulant fever, brucellosis is uncommon in the United States. Worldwide, brucellosis affects hundreds of thousands of people and animals in Mediterranean countries and other areas each year. The bacteria can spread through the air or through direct contact with infected animals.

Brucellosis can usually be treated successfully with antibiotics. Treatment takes several weeks, however, and relapses are common. Avoiding unpasteurized dairy products and taking precautions when working with animals or in a laboratory can help prevent brucellosis. Animals can be vaccinated against the disease. 

Symptoms

Symptoms of brucellosis may show up anytime from a few days to a few months after you're infected with brucella, the bacteria that cause brucellosis. Signs and symptoms are similar to those of the flu and include:

• Fever, often rising to 104 F (40 C) or more in the afternoon — a rising and falling (undulating) fever is one of the hallmarks of the disease
• Chills
• Sweats
• Weakness
• Fatigue
• Joint, muscle and back pain
• Headache

Brucellosis symptoms may disappear for weeks or months and then return. In some people, brucellosis becomes chronic, with symptoms persisting for years, even after treatment. Long-term signs and symptoms include fatigue, fevers, arthritis and spondylitis — an inflammatory arthritis that affects the spine and nearby joints.

When to see a doctor
Brucellosis can be hard to identify, especially in the early stages, when it often resembles the flu. See your doctor if you develop a rapidly rising fever, muscle aches or unusual weakness and have any risk factors for the disease, or if you have a persistent fever.

Causes:

         Brucellosis affects many wild and domestic animals. Cattle, goats, sheep, pigs, dogs, camels, wild boar and reindeer are especially prone to the disease. A form of brucellosis also affects harbor seals, porpoises and certain whales.

At least six species or strains of bacteria cause brucellosis in animals, but not all produce illness in humans. The bacteria spread from animals to people in three main ways:

• Raw dairy products. Brucella bacteria in the milk of infected animals can spread to humans in unpasteurized milk, ice cream, butter and cheeses. The bacteria can also be transmitted in raw or undercooked meat from infected animals.
• Inhalation. Brucella bacteria spread easily in the air. Farmers, laboratory technicians and slaughterhouse workers can inhale the bacteria.
• Direct contact. Bacteria in the blood, semen or placenta of an infected animal can enter your bloodstream through a cut or other wound. Because normal contact with animals — touching, brushing or playing — doesn't cause infection, people rarely get brucellosis from their pets. Even so, people with weakened immune systems should avoid handling dogs known to have the disease.

Brucellosis normally doesn't spread from person to person, but in a few cases, women have passed the disease to their infants during birth or through their breast milk. Rarely, brucellosis may spread through sexual activity or through contaminated blood or bone marrow transfusions.

Complications

By Mayo Clinic staff

Brucellosis can affect almost any part of your body, including your reproductive system, liver, heart and central nervous system. Chronic brucellosis may cause complications in just one organ or throughout your body. Possible complications include:

• Infection of the heart's inner lining (endocarditis). This is one of the most serious complications of brucellosis. Untreated endocarditis can damage or destroy the heart valves and is the leading cause of brucellosis-related deaths.
• Arthritis. Osteoarthritis is marked by pain, stiffness and swelling in your joints, especially the knees, hips, ankles, wrists and spine. Spondylitis — inflammation of the joints between the bones (vertebrae) of your spine or between your spine and pelvis — can be particularly hard to treat and may cause lasting damage.
• Inflammation and infection of the testicles (epididymo-orchitis). The bacteria that cause brucellosis can infect the epididymis, the coiled tube that connects the vas deferens and the testicle. From there, the infection may spread to the testicle itself, causing swelling and pain, which may be severe. Brucellosis can also affect the prostate gland and kidneys.
• Anemia. Anemia, in which you don't have enough healthy red blood cells, can cause pale skin, fatigue and shortness of breath.
• Skin rashes. Rashes and other skin problems are a rare complication of brucellosis.
• Miscarriage. Brucellosis may cause early pregnancy loss in some women.
• Hepatitis. Brucellosis can cause this serious liver disease, which, if not treated, can lead to liver scarring (cirrhosis) and ultimately to liver failure.
• Central nervous system infections. These include potentially life-threatening illnesses such as meningitis, an inflammation of the membranes surrounding the brain and spinal cord, and encephalitis, inflammation of the brain itself.

 Treatments and drugs

By Mayo Clinic staff

Treatment for brucellosis aims to relieve symptoms, prevent a relapse of the disease and avoid complications. You'll need to take medications for at least six weeks, and your symptoms may not go away completely for several months. The disease can also return and may become chronic.

Antibiotics
The standard treatment for brucellosis is a combination of two or three antibiotic medications, usually doxycycline in combination with streptomycin, rifampin or gentamicin. You'll take these drugs for six weeks or longer. If brucellosis has affected your central nervous system, you may need to take three antibiotics for as long as three months. Children and pregnant women can't take certain antibiotics, so their treatment may involve just one antibiotic or a different combination of drugs.