All about brucellosis. Predisposition to disease

Fortunately, pet owners rarely encounter truly “bad” diseases in their pets, which can pose a danger not only to them, but also to the person himself. Alas, there are such people. This includes brucellosis in cats.

This is an extremely dangerous, contagious, and practically incurable disease caused by Brucella (Brucella melitensis, abortus, suis, canis). This bacterium primarily affects the reproductive organs of animals. The disease can cause infertility and permanent abortions in cats. Brucellosis in cats can manifest as orchitis and epididymitis. Almost all kittens become infected at the stage of intrauterine development, the rest - during childbirth.

The disease can affect cats of any age, breed, and age group. It is transmitted through secretions from the genitals, mouth, and nasal cavity. A certain concentration of the pathogen is always found in milk, feces and urine. Although there are not so many bacteria in these biological secretions, a person takes a great risk by coming into contact with them. There is no specific “feline” causative agent of brucellosis in nature. These animals become ill through contact with sick dogs, people, or by eating meat and meat waste obtained from sick pigs or cows.

Important! Brucella is the only microorganism that does not require open wounds and ulcers on the skin to enter your body. The pathogen secretes a proteolytic enzyme, and therefore easily passes even through healthy skin!

Read also: Cloudy eye in a cat: main causes and treatment methods

Clinical signs and diagnosis

If your cat has brucellosis, the animal will show the following clinical signs:

Apathy, general weakness.

Swollen lymph nodes.

When walking, the cat is “numb”; it is clear that the movement causes pain to the animal.

Lower back pain.

Weak and sickly newborn kittens that very often die shortly after birth.

Vaginal discharge.

Swollen testicles.

Inflammation of the skin around the scrotum.

In many cases, brucellosis is not easy to detect until specific antibodies appear in the blood (and they can take a long time to appear). Until this time, symptoms may not appear. The final diagnosis is made only on the basis of serological reactions and PCR. All animals that showed a questionable result are considered sick. They are isolated and retested after three to six weeks. There are other diagnostic methods, although they are not used as often:

Since brucellosis causes destruction of cartilage tissue, and this is especially evident in the example of intervertebral discs, an X-ray of the spinal column is performed.

Cytology and plating on nutrient media.

Complete blood test and biochemistry.

But the only 100% method is ELISA and PCR (special reactions).

Treatment

If your cat shows a positive (or at least questionable) result, it should be immediately isolated from other animals and humans. Is there any treatment? Yes, some sources write about the relatively high effectiveness of modern broad-spectrum antibiotics, but not everything is so rosy. Firstly, the course of treatment will be very long and expensive. Secondly, relapses occur in more than 80% of cases. Thirdly, the “recovered” animal continues to be a carrier of the disease, posing a huge threat to people and other cats. Today there is an opinion that brucellosis should not be treated, since it is practically incurable. Sick animals are euthanized and the corpses are burned.

Brucellosis(lat. brucellosis) is a zoonotic infection transmitted from sick animals to humans, characterized by multiple lesions of organs and body systems.

Animal brucellosis

Pathogen

The causative agent is six species of Brucella: Br.melitensis, Br.abortus, Br.suis, Br.ovis, Br.canis, Br.neotome.

Epizootological data

Various types of warm-blooded animals (including dogs and cats) are susceptible. The most susceptible are sheep, goats, cattle, pigs, and camels. The source of infection is a sick animal that secretes Brucella. Infection occurs through the mucous membranes of the digestive tract with food and water, the conjunctiva, mucous membranes of the respiratory tract, and through the skin upon contact with infected animal secretions and objects. Particularly dangerous as a factor in the transmission of infection is infected milk and meat used as feed in an unneutralized form.

Course and symptoms

The incubation period is 2-3 weeks or more. It is chronic and in most cases asymptomatic. The main symptom of the disease is abortion and retained placenta. The producers have orchitis and epididymitis. Endometritis, mastitis, bursitis, and arthritis develop less frequently.

Brucellosis in dogs It is usually chronic and very often asymptomatic. In some cases, with such a sluggish disease, male dogs may develop lesions of the genital organs: epididymitis and orchitis with proliferation of lymphohistiocytic elements. In more severe cases, the parenchyma of the prostate and seminiferous tubules of the testes is destroyed and aspermatogenesis develops. That is, animals become infertile. In bitches, the main pathological reactions develop during pregnancy. In this case, dogs can abort on the 30-50th day of pregnancy or give birth to dead offspring. After this, they continue to experience inflammatory processes in the uterus for a long time. Fetal fluid and uterine discharge contain huge amounts of the pathogen and the animal during this period represents a dangerous source of infection, especially for its owners. In addition to lesions of the genital organs, dogs can sometimes experience enlarged lymph nodes. Relapsing-remitting fever is very rarely observed. In the literature there are descriptions of arthritis in dogs with brucellosis.

Brucellosis in cats proceeds secretly, asymptomatically, or the signs are not typical. The incubation period lasts 2 - 3 weeks. In the initial period, there is a slight increase in body temperature, lethargy, and decreased appetite. Later, inflammation of the testes and appendages may develop in cats, and abortion or retention of the placenta with subsequent inflammation of the uterus in cats. Sometimes damage to joints and synovial bursae occurs. The disease can last for years.

Diagnosis

The diagnosis is established only on the basis of the results of epizootological, clinical, serological, allergic, and bacteriological studies.

For farm animals, the diagnosis is considered established: in previously prosperous farms - with positive results of bacteriological examination, as well as in the case of persistence of serological and allergic reactions in animals suspicious for the disease during repeated examinations; in farms unaffected by brucellosis - when identifying animals that react positively during serological and allergic testing.

Prevention and control measures

Animals should not be allowed to eat raw meat or organs, slaughterhouse waste, raw milk or cream. Scheduled preventive diagnostic examinations once a year. The improvement of dysfunctional areas is carried out either by systematic diagnostic tests of animals to identify patients with their subsequent slaughter, or by a one-time complete replacement of the population of a dysfunctional herd with healthy animals. The use of anti-brucellosis vaccines for immunization of large and small ruminants is carried out as part of a set of instrumental measures to combat this disease in accordance with the instructions for their use.

Human brucellosis

Synonyms: Maltese fever, Cyprus fever, Gibraltar fever, undulant fever.

Pathogen

The causative agent of the disease is a group of microbes of the genus Brucella. Four pathogenic to humans are: Maltese Brucella (Brucella melitensis), bovine Brucella (Brucella abortus bovis), porcine Brucella (Brucella abortus suis) and canine Brucella (Brucella canis).

Epidemiology

The source of Brucella, which is dangerous to humans, is mainly goats, sheep (B. melitensis), cows (B. abortus bovis) and pigs (B. abortus suis), which excrete the pathogen in milk, urine, and amniotic fluid. Human infection occurs through direct contact with carrier animals or through consumption of contaminated foods - raw milk, cheese made from unpasteurized milk. The causative agents of brucellosis - bacteria of the genus Brucella - tolerate low temperatures and freezing well, persist in water for up to 5 months, in soil - 3 months. and more, in cow's milk - up to 45 days, in feta cheese - up to 60 days, in butter, cream, yogurt and fresh cheeses - throughout the entire period of their nutritional value; in frozen meat - St. 5 months, in salted skins - 2 months, in wool - up to 3-4 months. When milk is boiled and pasteurized, brucellae die. Disinfectants kill bacteria within minutes.

Pathogenesis

Gates - microtraumas of the skin, mucous membranes of the digestive and respiratory tract. There are no changes at the gate site. There are no changes in the lymphatic pathways of the regional lymph nodes. Lymphadenopathy in brucellosis is generalized, which indicates hematogenous dissemination of microbes. Reproduction and accumulation in lymph nodes - periodically into the blood. Pronounced allergic restructuring of the body, pronounced delayed-type hypersensitivity, persists for a long time after cleansing the body of the pathogen. Brucellosis tends to be chronic. Immunity is formed, but it is not long-lasting (reinfection is possible for 3-5 years). The manifestations of brucellosis are significantly influenced by the type of Brucella that causes the disease. The most severe course of brucellosis is melitensis, the rest cause milder diseases.

Clinical picture

The incubation period is 1-2 weeks, if it begins as a primary latent period - several months. The disease usually develops gradually and has no specific features. But patients usually present four main complaints:

intermittent pain in the joints, mainly in the lower extremities, sometimes very strong and painful.
increase in body temperature in the form of a prolonged low-grade fever (up to 38 ° C) or a wave-like type with sharp rises and falls.
increased sweating, perspiration, sometimes night sweats.
severe weakness and loss of strength.

Systemic lesions are diverse and affect almost all organs. Meet:

Musculoskeletal system

septic monoarthritis, asymmetric polyarthritis of the knee, hip, brachial sacroilial and sternoclavicular joints, spinal osteomyelitis, myalgia.

Heart

endocarditis, myocarditis, pericarditis, aortic root abscess, thrombophlebitis, and endocarditis can also develop on previously unchanged valves.

Respiratory system

bronchitis and pneumonia.

Digestive system

anicteric hepatitis, anorexia and weight loss.

Genitourinary system

epididymitis, orchitis, prostatitis, tubo-ovarian abscess, salpingitis, cervicitis, acute pyelonephritis.

Central nervous system

meningitis, encephalitis, meningoencephalitis, myelitis, cerebral abscesses, Guillain-Barré syndrome, optic nerve atrophy, lesions of III, IV and VI pairs.

Lymph nodes, spleen

lymphadenitis, enlarged spleen

Eyes

keratitis, corneal ulcers, uveitis, endophthalmitis.

Approximate frequency of medical history and some symptoms/complaints in patients with brucellosis (in%)

Forms

Acute— lasting up to 1.5 months;
subacute- duration 1.5-3 months;
chronic- more than 3 months.

Diagnosis

History data: contact with animals, consumption of thermally unprocessed animal products, specialty of the patient, endemic foci.
Clinical picture.

Prevention

Pasteurization or boiling of milk, meat processing
Sanitary and hygienic education of the population working with animals or their products
Preventive vaccinations for high-risk individuals (short period of validity - about 2 years)

Brucellosis

Brucellosis is a chronic infectious disease of domestic and some wild animals, which also poses a danger to humans. It occurs relatively rarely in dogs and cats, but mainly in those who have contact with farm animals (live on farms, guard flocks).

The causative agent of brucellosis is very small, non-spore-forming bacteria of the genus Brucella of several species.

Pasteurizing milk at 70°C kills Brucella within 30 minutes. They can persist for several weeks on environmental objects contaminated with animal excretions.

Dogs and cats can become infected with any type of Brucella (melitensis, abortus, suis, ovis). Recently, a canine species, Brucella canis, was discovered in the United States, the role of which has not yet been sufficiently studied.

Animals become infected by eating meat, internal organs, milk from cows, sheep, pigs with brucellosis, or aborted fetuses. It has been established that rodents and hares can be carriers of Brucella. It has been noted that bitches and cats during pregnancy exhibit a higher susceptibility to brucellosis. Patients are very dangerous for humans and farm animals.

Brucellosis in dogs and cats usually occurs latently, without pronounced symptoms or with unusual signs. The incubation period lasts from 2 to 3 weeks.

At the onset of the disease, body temperature rises slightly, appetite decreases, and the animal becomes lethargic. In the future, males may develop inflammation of the testes and their appendages, and females may experience abortion or retained placenta with inflammation of the uterus. Sometimes joints and synovial bursae are affected. In this form, the disease can last for years.

Taking into account the existing clinical signs, it can be assumed that the animal has a disease. To confirm the diagnosis, laboratory tests should be performed on aborted fetuses, uterine secretions, parenchymal organs of killed animals to identify the pathogen, or blood serum to detect antibodies to Brucella.

Sick animals are not treated and must be destroyed.

For the purpose of prevention, in farms where brucellosis has been observed in farm animals, do not allow cats and dogs to eat aborted or premature fetuses, as well as raw meat and milk. On these same farms, dogs and cats are promptly examined for brucellosis.

Operating personnel must strictly follow the rules of personal hygiene and prevention.

If, when keeping dogs and cats in groups (kennels, vivariums), they develop brucellosis, measures should be taken in accordance with the “Instructions for the prevention and elimination of brucellosis.”

From the book Our four-legged friends author Slepnev Nikolay Kirillovich

Brucellosis Brucellosis is a chronic infectious disease of domestic and some wild animals, which also poses a danger to humans. It occurs relatively rarely in dogs and cats, but mainly in those that have contact with agricultural products.

From the book How to Treat Your Dog author Antonova Lyudmila

Brucellosis The causative agent of the disease is bacteria that infect the genitals of dogs. External manifestations of the disease are enlarged lymph nodes in the groin area and under the lower jaw. Another symptom of the disease may be swelling of the joints. U

From the book Central Asian Shepherd Dog author Ermakova Svetlana Evgenievna

Brucellosis Among zooanthroponotic infections, brucellosis, which affects the reproductive organs of Central Asian Shepherd dogs, occupies a special place. It is always chronic and almost asymptomatic, appearing only during the breeding season. Causing the disease

From the book Hounds author Maskaeva Yulia Vladimirovna

Brucellosis Among zooanthroponotic infections, brucellosis, which affects the reproductive organs, occupies a special place. It is always chronic and almost asymptomatic, appearing only during the breeding season. There are 4 types of bacteria that cause the disease

From the book Rottweilers author Sukhinina Natalya Mikhailovna

Brucellosis Among zooanthroponotic infections, brucellosis, which affects the reproductive organs of Rottweilers, occupies a special place. The disease is always chronic and is almost asymptomatic, appearing only during reproduction periods. Bacteria that cause the disease

From the book Cattle Diseases author Dorosh Maria Vladislavovna

Brucellosis This is a chronic disease of animals and humans, characterized by abortion, retention of the placenta, inflammation of the uterine mucosa and often damage to the joints. The causative agent - the bacterium Brucella - is not resistant to disinfectants, for example

From the book Diseases of Sheep and Goats author Dorosh Maria Vladislavovna

Brucellosis Brucellosis is a chronic disease of animals and humans, characterized by abortion, retention of the placenta, inflammation of the uterine mucosa and often damage to the joints. The causative agent is the bacterium Brucella - is not resistant to disinfectants, for example

From the book Diseases of Pig author Dorosh Maria Vladislavovna

Brucellosis Brucellosis is a chronic disease of animals and humans, characterized by abortion, retained placenta, inflammation of the uterine mucosa and often joint damage. The causative agent is the bacterium Brucella, which is not resistant to disinfectants, and boiling

The main causative agent of brucellosis is Brucella canis. These are fairly small, gram-negative, intracellular bacteria of the genus cocci. There are also other types of Brucella - for example, B. abortus, B. Suis, B. Ovis, but they are less contagious and are less common in sick animals.

Brucellosis was first described in 1966 as the main cause of numerous abortions in breeding lines. Isolation of bacteria from the vagina after an abortion continues for 6-7 weeks. B. Canis is excreted in urine and semen for about 3 months. Brucellosis is more common in Mexico and Central/South America (20-30%), slightly in Europe, China and Japan (7-8%).

Routes of infection.

Brucellosis can be transmitted through contact with aborted fetuses and placenta, through vaginal discharge of sick bitches, and from mother to puppies. Infection occurs through the mucous membranes of the mouth (for example, through accidental consumption of particles of an infected placenta or aborted fetus, vaginal secretions of infected bitches), through the mucous membranes of the penis and vagina (during sexual contact), conjunctiva, when the number of bacteria is at least 104-106 in the infected material.

Once in the body, the pathogen lives inside cells, multiplies there, and after 1-4 weeks, as a macrophage, it can spread throughout the body for almost 36 months. Moreover, for the first few months the disease does not manifest itself in any way; the formation of antibodies occurs without any signs of fever, lethargy or deterioration in general condition. In most cases, the body's protective functions are not able to independently prevent colonization of the pathogen. The placenta, spleen, lymph nodes, prostate gland and epididymis are primarily affected.

Clinical signs.

Clinical signs are associated primarily with dysfunction of the reproductive system. Abortions caused by B. canis usually occur in bitches between 45 and 55 days, although early fetal resorption, stillbirth or very weak births, metritis and infertility are also possible. In male dogs, epididymitis of one or both testicles, atrophy of the testicles and scrotum, scrotal dermatitis, orchitis, prostatitis, a large number of abnormal sperm and inflammatory cells in the seminal fluid with subsequent infertility may be observed. Rare manifestations of brucellosis are pyogranulomatous (similar to licking dermatitis), glomerulonephritis, recurrent anterior retinal detachment. With sporadic diseases of the spine, animals experience back pain, which is caused by discospondylitis and osteomyelitis due to Brucella damage to the capillary area of the vertebral end plates. Spontaneous recovery occurs after 1-3 years with the formation of lifelong immunity. Brucellosis does not pose any danger to the life of an animal. Some females, after suffering from the disease, are able to bear healthy offspring, while in males, in most cases, testicular atrophy and infertility are observed.

The risk of zoonosis due to brucellosis is quite small, since people are not very susceptible to the pathogen and get sick much more easily, but you should be careful when dealing with bitches after abortions. Cats can also become infected with brucellosis, but the disease is very mild.

Diagnostics.

To diagnose brucellosis, serological tests with delay agglutination (RA), immunofluorescence (ELISA), or complement binding reaction (CBR) with paired sera taken after 2 weeks are often used. However, these methods should be used no earlier than 3-5 weeks after the suspected infection. It is also possible to use rapid slide agglutination tests, but this method is mainly applicable to B. ovis. Diagnostic titers when studied using serological tests are considered to be titers of 1:200 and higher, although there is data on the diagnostic informativeness of titers of 1:100.

Currently, PCR is also widely used to diagnose brucellosis, the material for which can be blood with EDTA, synovial fluid, amniotic fluid, aborted fetus, lymph nodes, milk and sperm.

Treatment.

Brucellosis is quite difficult to treat due to the intracellular localization of the pathogen, even with antibiotics that are effective in vitro. Males must be neutered after diagnosis. After treatment and a long break, bitches can be used again in breeding work, but the possibility of relapse and bacteremia should be taken into account even after a few months.

The most effective treatment is considered to be used or in combination with minocycline.

Prevention.

To prevent brucellosis, doctors at the Zoovet veterinary center recommend excluding infected animals from breeding and creating new breeding lines with animals that have undergone multiple serological controls at intervals of 30 days.

Brucellosis in humans is a zoonotic infectious disease that primarily affects the reticuloendothelial, musculoskeletal, vascular and nervous systems. The disease is also called Maltese or Mediterranean fever, Bang's disease or Bruce's disease. It is caused by bacteria of the genus Brucella. The source of pathogens is most often animals such as goats and sheep, less often cattle. Brucellosis is a socially dangerous disease, and therefore it is included in the list. Treatment is carried out with antibacterial drugs.

Rice. 1. Abortion, retained placenta and testicular inflammation are the main manifestations of brucellosis in animals.

The causative agent of brucellosis

The cause of the disease is gram-negative bacteria of the genus Brucella, which includes 6 independent species, divided into a number of biovars.

melitensis(3 biovars) most often affects humans. The main hosts are sheep and goats.
abortus(9 biovars). The main host is cattle.
suis(4 biovars). The main hosts are pigs, hares, reindeer, horses, camels and yaks.
Much less often the disease in humans is caused by canis, whose main owners are dogs.

Brucella has sufficient resistance in the external environment. Bacteria remain viable for more than 2 months in water, about 3 months in raw meat, about 1 month in salted meat, from 20 to 70 in dairy products and raw milk, up to 2 months in feta cheese, up to 4 months - in wool.

When boiled, brucellae die instantly. When heated to 60°C they die within 30 minutes. Bacteria exhibit resistance to low temperatures and even freezing. Known disinfectants (carbolic acid, creolin, Lysol, bleach) kill pathogens within a few minutes.

Foci of brucellosis have been registered on all continents of the earth. The disease is common in regions where livestock farming is developed - Central Asian countries, in the Russian Federation these are the Krasnodar and Stavropol Territories, the Southern Urals and Kazakhstan. The infection is common among shepherds, shepherds, milkmaids, veterinary and livestock workers, workers in meat processing plants, slaughterhouses and wool processing factories.

The source of pathogens is most often goats and sheep, less often - cattle.

The most severe cases of the disease are recorded during infections
In cases of infection abortus the disease is mild, and the patient himself is not dangerous to others.

Rice. 3. The photo shows animals that are sick and spreading the disease.

Mechanism of transmission of Brucella

The main route of transmission of infection is nutritional. Infection occurs through dairy products (milk, cheese, feta cheese and kumys), meat (stroganina, shish kebab with blood, raw minced meat), animal wool and skin.
Pathogens can enter the human body through contact and household contact. Damaged skin and mucous membranes are entry points for infection when working with newborn lambs and calves (care, manual separation of placenta), and when processing animal carcasses. Brucella can penetrate the human body even through intact mucous membranes.
Soil, bedding, feed and water contaminated with bacteria become infection factors.
When working with the hair of sick animals (cutting, sorting wool, combing out fluff), bacteria enter the human body with the air-dust mixture.
Cases of infection of laboratory workers through aerogenous routes have been reported.

Infected raw milk, sheep's cheese and unaged cheeses are the main food products that can cause brucellosis when consumed.

Brucellosis in animals

As in humans, after infection of animals, Brucella enters regional lymph nodes, where they multiply and accumulate. Signs of pathology appear after bacteria enter the bloodstream and disperse throughout the body. The animal becomes a bacteria carrier and begins to release pathogens into the external environment, contaminating the soil, bedding, feed and water with bacteria, which in turn become infection factors.

Once bacteria enter the placenta, they disrupt its functioning and the development of the embryo stops. Abortion occurs at 4-5 months of pregnancy (in cattle). In the case when young animals are born in a timely manner, they are not viable.

In cows, often the only symptom of the disease is abortion and its consequences, which is manifested by endometritis, retained placenta, mucous discharge from the genitals, mastitis and udder edema.
In dogs, the disease is often asymptomatic and has a chronic course.

Stillbirth of the fetus, inflammation of the walls of the uterus, inflammation of the mammary gland, inflammation of the joints, testicles and foreskin are signs of brucellosis in animals. The fetus, its membranes, amniotic fluid and milk of a sick animal are a source of Brucella. Full recovery of animals occurs after 3 - 5 years.

Rice. 4. Symptoms of inflammation of the foreskin and testicles (orchitis) are often recorded in sick bull animals.

Rice. 5. Stillbirth of the fetus in animals is one of the main symptoms of the disease.

Rice. 6. Inflammation of the joints is one of the main symptoms of the disease.

How does brucellosis develop in humans?

Incubation period

Once in the human body, Brucella leaves no traces in the area of penetration (entrance gate). Bacteria penetrate through the lymphatic ducts into regional lymph nodes, where they multiply and accumulate. This period is called incubation. It varies in duration for different people and depends on the person’s immunity and the number of pathogens. During this period, the body produces and accumulates antibodies, and the test for brucellin becomes positive. The average incubation period is 2 - 4 weeks.

Period of hematogenous dissemination

At the end of the incubation period, pathogens and their toxins penetrate into the blood (bacteremia and toxinemia), and a clinical picture of acute brucellosis develops. Toxic-allergic reactions occur. Bacterial toxins primarily affect the autonomic nervous system.

Local lesion phase

During the phase of local lesions, bacteria are fixed in organs rich in reticuloendothelium. Macrophages are activated and en masse capture Brucella, and diffuse changes in the form of specific granulomas develop in the affected organs. When the disease occurs, the clinical picture is dominated by signs of damage to the musculoskeletal system and nervous system.

The sensitized organism responds with delayed and immediate types of allergic reactions. The disease lasts a long time and often becomes chronic. New inflammatory (metastatic) foci are constantly formed, the formation of which is based on autoimmune processes. Over time, persistent scar changes develop in organs and systems.

Immunity in brucellosis

Immunity to the disease is short-lived and averages 6 to 9 months. With brucellosis, cross-immunity can be created. Patients with bovine brucellosis develop strong immunity.

Humans have an increased susceptibility to brucellosis.

Forms of brucellosis in humans

Acute form of the disease

The acute form of brucellosis is established in patients whose clinical symptoms appear within 3 months.

With a gradual start diseases (more often in elderly patients) weakness, malaise, weakness, poor sleep, muscle and joint pain, low-grade body temperature are the main symptoms of brucellosis during this period. Peripheral lymph nodes are slightly enlarged (micropolyadenopathy). As symptoms of intoxication increase, body temperature rises significantly. The patient experiences heavy sweats and chills. The liver and spleen enlarge.

With the rapid development of the disease (acute form) body temperature rises to 39 - 40°C. The temperature curve has a wave-like shape, often of an irregular type. The patient experiences heavy sweats and chills, but overall health remains satisfactory. Peripheral lymph nodes are enlarged, some of them are painful on palpation. Painful formations are palpated under the skin - cellulitis and fibrositis. By the end of the first week, the liver and spleen enlarge. There are no focal lesions. ESR and leukocytes remain within normal limits or are slightly elevated.

Rice. 7. The photo shows a wave-shaped temperature curve.

Subacute form of the disease

The subacute form of brucellosis is established in patients whose clinical symptoms appear within 3 to 6 months. The disease is characterized by a relapsing course. The patient's body temperature bothers him for several days. Muscle and musculoskeletal pain, paresthesia, poor sleep and appetite, muscle weakness are the main symptoms of brucellosis during this period. Allergic manifestations in the form of exanthems and dermatitis are observed on the skin. In some cases, with severe disease, signs of infectious-allergic endocarditis, myocarditis and pericarditis are found. In 10 - 15%, a clinical picture of damage to the musculoskeletal system, peripheral nervous system and genital area develops.

Rice. 8. Allergic manifestations in the form of exanthems and dermatitis are often observed on the skin during the disease.

Chronic form of the disease

Currently, severe and acute forms of brucellosis are rare. Chronic forms are more common, occurring with relapses and frequent exacerbations.

Chronic brucellosis is characterized by great variability in clinical manifestations. The symptoms of intoxication are weakly expressed. Periods of exacerbations and remissions follow each other at intervals of 1 - 2 months. When fresh lesions appear, the patient's condition worsens. The disease lasts 2-3 years and is characterized by complex organ damage. There are visceral, osteoarticular, urogenital and nervous forms of chronic brucellosis. Combinations of different forms of the disease are often recorded.

A sick person does not pose a danger to others

Signs and symptoms of brucellosis in humans

Fever

In the past, fever in brucellosis was an important symptom of the disease. Currently, the majority of patients have low-grade fever, and in 1/3 of patients the disease occurs with normal temperature. Less often, the temperature has a wave-like character.

Enlarged lymph nodes

In the initial stage of the disease, regional lymph nodes enlarge. Further, during hematogenous dissemination, bacteria accumulate in all peripheral lymph nodes. Lymph nodes are small and very dense, no more than 0.7 mm in diameter (micropolyadenopathy).

Rice. 9. When the disease occurs, a rash like urticaria often appears on the skin.

Signs and symptoms of the disease with damage to the musculoskeletal system

The musculoskeletal system is the first to be affected by brucellosis. Muscle and joint pain appears. Pain is the main symptom of brucellosis when the musculoskeletal system is affected. The process involves mainly large joints. The inflammatory process affects both the joint itself and the joint capsule, tendons, periosteum and perichondrial tissue. With a long course, joint destruction is observed due to the proliferation of bone tissue (there is no osteoporosis). The joints swell. Mobility in them is limited. The skin over the joints does not change color.

The disease often affects the joints. Damage to the sacroiliac joint has significant diagnostic value.

The pain in the affected muscles is dull and prolonged. Painful lumps are palpable in the thickness of the muscles.

Inflammation of the fascia and aponeuroses (fibrositis) is recorded in the subcutaneous tissue of the legs, forearms, back and lumbar region. Tumor-like formations are from 5 mm to 4 cm, oval in shape, painful on palpation. Over time, fibrositis resolves or thickens and remains in this form for life.

Sacroiliitis (inflammation of the sacroiliac joint) and spondylosis (damage to the spine) are typical signs of brucellosis when the musculoskeletal system is affected.

Rice. 10. The photo shows brucellosis in a person. The tendon sheaths are affected.

Rice. 11. Knee joints are affected (brucellosis arthritis).

Rice. 12. The photo shows brucellosis in a person. On the left is brucellous spondylitis of the lumbar spine. On the right is bilateral brucellosis sacroiliitis. The widened gaps of the sacroiliac joints with uneven contours are clearly visible.

Signs and symptoms of the disease with damage to the nervous system

Brucellosis often affects the nervous system. Plexitis, ischioradiculitis, intercostal neuralgia, neuritis of the auditory and optic nerves, sensitivity disorders are the main symptoms of brucellosis when the peripheral nervous system is affected.

The central nervous system is affected less frequently, but the disease is severe and long-lasting. Myelitis, encephalitis, arachnoiditis, meningitis are the main symptoms of brucellosis when the central nervous system is affected.

Hyperhidrosis, phenomena of vegetative-vascular dystonia, neuroses and reactive states are characteristic manifestations of a disorder of the autonomic nervous system.

Rice. 13. The photo shows brucellosis in a person. Computed tomography shows a large area of meningoencephalitis on the left.

Signs and symptoms of the disease in the genital area

Inflammation of the testicle (orchitis) and epididymis (epididymitis) are characteristic symptoms of brucellosis in men. Menstrual disorders, endometritis, salpingitis, spontaneous abortion, stillbirth and premature birth are characteristic symptoms of brucellosis in women. Pregnancy often has a negative effect on the course of the disease.

Consequences of the disease

The consequences of brucellosis are functional.

When the autonomic nervous system is damaged after brucellosis, patients continue to have sweating, symptoms of neurosis and changes in the neuropsychic sphere.
When the nervous system is damaged, when the disease has resulted in the formation of fibrous-scarring changes in the area of nerve roots, trunks and plexuses, all sorts of neurological symptoms are recorded.
When the musculoskeletal system is damaged, ankylosis, contractures and spondylosis develop, often requiring surgical treatment.

Diagnosis of brucellosis

Clinical and epidemiological data and confirmation of the disease by laboratory tests are the basis for the diagnosis of brucellosis.

General blood test

A distinctive feature of the disease is leukopenia and lymphocytosis in the blood. The erythrocyte sedimentation rate (ESR) increases moderately.

Features of the clinical picture

Prolonged fever.
The patient's condition is satisfactory at high temperature.
Micropolyadenopathy.
The appearance of fibrositis and cellulite.
Numerous and varied patient complaints associated with multiple organ damage.

Bacteriological diagnostics

Bacteriological diagnosis of brucellosis is carried out only in specialized (“high-security”) laboratories, which is due to the high contagiousness of Brucella bacteria. Blood, lymph node punctures, cerebrospinal fluid and bone marrow are the main types of biological material for research. The pathogen seeding rate is low.

Specific tests

Serological diagnosis

Serological tests are widely used in the diagnosis of brucellosis, allowing the detection of antibodies and the increase in antibody titer during the disease (Wright reaction, RSK, RIF, RNGA). The Wright agglutination reaction is very informative in the acute period. In the chronic form of the disease - Coombs reaction.

Brucella lysis reaction under the influence of the patient's blood serum.

Burnet allergy skin test is highly sensitive. It becomes positive already in the first month of the disease.

Accelerated Heddleson reaction used in mass research.

Serological tests to detect antibodies to Brucella melitensis - the main tests for brucellosis

Rice. 14. The photo shows Brucella abortus (view under a microscope) on the left and Brucella melitensis (view under a microscope) on the right (Kozlovsky staining). Brucella are colored red.

Rice. 15. The photo shows brucella. Growth on solid nutrient medium.

Treatment

The basis of treatment for brucellosis is antibacterial therapy. The treatment regimen includes two antibacterial drugs, one of which has the ability to penetrate the cell membrane.

Rifampicin + Doxycycline
Doxycycline + Streptomycin
Rifampicin + Ofloxacin

Detoxification therapy.
Use of immunomodulators.
If the nervous system and musculoskeletal system are affected, non-steroidal anti-inflammatory drugs are prescribed. For severe pain, novocaine blockades are indicated.
Glucocorticoids in the treatment of brucellosis are used strictly according to indications and with great caution.
During the period of remission and during recovery, physiotherapeutic treatment is indicated (paraffin baths, UHF, diathermy, Sollux and radon baths and quartz).
During the recovery period, sanatorium treatment is indicated at the resorts of Sernovodsk, Pyatigorsk, Tskaltubo, Sochi-Matseste, and Goryachy Klyuchi.

Rice. 16. Sanatorium treatment for the disease is indicated during a period of stable remission.

Prevention of brucellosis

Epidemiological surveillance is based on the assessment of epizootic and epidemic situations. are carried out in close contact with the sanitary-epidemiological and veterinary services. Diseases among animals and people are identified, and risk factors for their occurrence are assessed.

A set of veterinary, sanitary and health measures for brucellosis:

Systematic examination of livestock for brucellosis in areas affected by the disease.
Elimination of sick animals.
Carrying out active immunization of animals.
Immunization of permanent and temporary workers of livestock farms and meat processing plants.
Disinfection of raw materials and products.
Disinfection of premises where livestock are kept with a solution of bleach, formaldehyde or a soap-cresol mixture.
Teenagers, pregnant women and people with chronic diseases are not allowed to work related to caring for animals.
Persons caring for animals are provided with special clothing and trained in the use of disinfectants.
Conducting periodic preventive examinations of personnel involved in working with animals, raw materials and products (at least once a year).
Patients with brucellosis are not dangerous to others, so they do not need isolation.
People who have had brucellosis are under dispensary observation for 2 years.
Persons in contact with sick animals are examined for brucellosis once every 3 months.
Emergency prophylaxis is carried out with the antibiotics rifampicin, doxycycline and tetracycline.
All about brucellosis