Infectious diseases. Brucilosis. Clinic. Diagnostics. Treatment. Prevention (most important)

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Infectious diseases. Brucilosis. Clinic. Diagnostics. Treatment. Prevention (most important)

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31. Brucilosis. Clinic. Diagnostics. Treatment. Prevention

Clinical manifestations. The incubation period varies from several days to several months. The disease most often begins unnoticed, but acute sudden development of clinical signs of infection is possible; in endemic areas, the disease in children usually proceeds unnoticed. Prodromal symptoms are weakness, fatigue, anorexia, headaches, myalgia, and constipation. As the disease progresses, there is an increase in body temperature in the evening, which soon reaches 41-42,5 ° C. There are chills, profuse sweating, nosebleeds, abdominal pain and coughing. Often there is a significant decrease in body weight.

Physical examination reveals an enlarged liver and spleen, hyperplasia of the cervical and axillary lymph nodes. Wheezing may be heard in the lungs, in which case changes in them are visible on chest radiographs.

Chronic forms of brucellosis are difficult to diagnose and are often interpreted as a fever of unknown origin. Patients complain of fatigue, muscle and joint pain, sweating, nervousness and lack of appetite. Cases of depression and psychosis have been described. A maculopapular (more rarely, morbilliform) rash may appear. Brucellosis is often accompanied by the development of uveitis, endocarditis, hepatitis, cholecystitis, epididymitis, prostatitis, osteomyelitis, encephalitis and myelitis.

Diagnosis. Diagnosis of the disease is carried out on the basis of anamnestic data, epidemiological history, an objective examination of the patient, as well as a number of laboratory tests, including:

1) serological research methods;

2) intradermal allergic test Burne.

Treatment. Patients with brucellosis are prescribed bed rest and an easily digestible high-calorie diet. Treatment with tetracycline is carried out for 3-4 weeks. Relapses of the disease occur in 50% of patients.

In these cases, increase the dose of tetracycline and add streptomycin for a period of 2 weeks. During the 2nd week, the initial dose of drugs is halved. It is also recommended to prescribe rifampicin in combination with trimethoprim-sulfamethoxazole or moxalactam.

Other third-generation cephalosporins have been reported to have an effect on Brucella in vitro, but clinical studies are not yet available.

Limited abscesses must be opened and drained.

Corticosteroids may be useful only in the initial period of treatment to prevent the Herxheimer's reaction.

Prevention. The prevention of brucellosis consists in the exclusion of human contact with the sources of the disease. Infection in domestic animals with which a person is in constant contact can be prevented by vaccination.

Along with the vaccination of animals and the pasteurization of milk, it is necessary to periodically carry out agglutination reactions with the blood and milk of animals, which makes it possible to identify infected animals. The latter are to be slaughtered. Eating unpasteurized milk and products from it should be excluded.

Author: Pavlova N.V.

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