Infectious diseases. Brucellosis. Etiology. Epidemiology. Pathogenesis and pathomorphology (most important)

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Infectious diseases. Brucellosis. Etiology. Epidemiology. Pathogenesis and pathomorphology (most important)

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30. Brucellosis. Etiology. Epidemiology. Pathogenesis and pathomorphology

Brucellosis is an acute or chronic disease of livestock transmitted to humans mainly by four types of brucella - from cows, goats, pigs and dogs.

Etiology. Six species of Brucella are known that can cause disease in humans: B. abortus (source - cow), B. melitensis (source - goat), B. suis (source - pig), B. canis (source - dog), B. ovis (sources - sheep and hare) and B. neotome (source - wood rat).

The causative agents of brucellosis are small gram-negative, immobile, aerobic rods that do not form spores and capsules, characterized by slow growth on nutrient media.

Epidemiology. Human brucellosis is caused by direct contact with sick animals. Most often, people who care for livestock get sick. Raw milk of sick animals, butter, cream, cottage cheese, ice cream can be sources of infection. The pathogen can enter the eye, nasopharynx, genitals, but intact healthy skin is impervious to it. Brucella remain viable when storing infected products in a refrigerator for 3 weeks and during the production (smoking) of ham. They die during pasteurization and boiling.

Pathogenesis and pathomorphology. Brucella are intracellular parasites. After entering the human body, they are phagocytosed by leukocytes and macrophages, spreading in the reticuloendothelial tissue. Pathogens can multiply in different cells, including erythrocytes.

Infection with brucellosis is accompanied by the development of delayed-type hypersensitivity to the brucellosis antigen. The patient's body reacts to a brucellosis infection by producing antibodies, among which are agglutinins, bacteriolysins, opsonins, precipitins and complement-fixing antibodies.

Serum or plasma of healthy individuals and patients in the acute phase of the disease, when complement is added, has a pronounced non-specific bactericidal activity against Brucella. In chronic forms of infection, specific antibodies appear that prevent the action of the "serum-complement" system, act as opsonins and increase the phagocytic activity of polymorphonuclear and mononuclear cells, due to which Brucella quickly disappear from the blood of patients with a high antibody titer, but remain in the cells, in which the action of antibodies is not manifested.

All types of Brucella cause granulomatous changes detected by histological examination of the liver, spleen, lymph nodes and bone marrow. There are signs of central lobular necrosis and cirrhosis of the liver. Granulomatous inflammation develops in the gallbladder, there are signs of interstitial orchitis with scattered areas of fibrous atrophy. Endocarditis with thickening of the aortic valve and atrioventricular orifice is also commonly found, and granulomatous changes in the myocardium, kidneys, brain, and skin have been described.

Author: Pavlova N.V.

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