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Brucellosis

(Undulant Fever; Bang’s Disease; Malta Fever)

En Español (Spanish Version)

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Brucellosis is a rare bacterial disease that causes fevers to come and go.

Causes

Brucellosis is caused by the bacterium Brucella. This bacterium infects domesticated animals. It can be spread to humans through:

  • Drinking unpasteurized milk from infected cows, sheep, or goats
  • Eating dairy foods from infected cows, sheep, or goats
  • Inhaling the bacteria
  • Breastfeeding—passed from an infected mother to an infant
  • Sexual transmission
  • Tissue transplantation

Risk Factors

Factors that increase your risk of getting brucellosis include:

  • Working with domesticated animals and livestock, especially sheep, goats, cattle, deer, elk, and pigs, or their waste products, bodily fluids, or carcasses
  • Eating undercooked meat products
  • Living in or travel to high-risk areas
  • Sex: male, possibly due to occupational exposure among farmers, ranchers, veterinarians, people working in tanneries, and slaughterhouse workers

Symptoms

Symptoms of brucellosis usually appear within two weeks of infection. Symptoms can appear from five days to several months after infection.

In the early stage, symptoms may include:

  • Discomfort
  • Sluggishness
  • Headache
  • Muscle pain
  • Fever
  • Chills
  • Severe headache and backache
  • Nausea, vomiting, and diarrhea
  • Rash
  • Abdominal fullness or discomfort
  • Joint pain

As it progresses, brucellosis causes a high fever (104° F to 105° F). This fever occurs in the evening along with severe sweating. It becomes normal or near normal in the morning, and usually begins again at night.

This on and off fever usually lasts 1 to 5 weeks. After 5 weeks, symptoms usually improve or disappear for two days to two weeks. Then, the fever returns. In some patients, this fever returns only once. In others, the disease becomes chronic, and the fever returns, lessens, and then returns again over months or years.

In later stages, brucellosis can cause:

  • Loss of appetite
  • Weight loss
  • Abdominal pain
  • Headache
  • Backache
  • Joint pain
  • Weakness
  • Irritability
  • Insomnia

Patients usually recover within 2 to 5 weeks. Rarely, complications can develop. These may include:

  • Abscesses within the liver or spleen
  • Enlargement of the liver, spleen, or lymph nodes
  • Inflammation and infection of organs in the body, such as:
    • Heart—endocarditis
    • Brain and brain lining—meningitis
    • Bones—osteomyelitis, especially the spine
    • Lungs—bronchitis and pneumonia
    • Eyes—uveitis, choroiditis, and papilledema
  • Scrotal swelling

Endocarditis

Bacterial endocarditis, aortic valve
Copyright © Nucleus Medical Media, Inc.

Brucellosis is also believed to cause a high rate of miscarriage during early pregnancy in infected women.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Your doctor may need to test your bodily fluids. This can be done with:

  • Blood tests
  • Urine tests
  • Bone marrow tests
  • Spinal fluid tests
  • Tissue tests

Your doctor may need pictures of your bodily structures. This can be done with:

Treatment

Many patients recover from brucellosis on their own. However, early diagnosis and treatment can reduce the risk of complications and infection. Talk with your doctor about the best treatment plan for you. Treatment options include:

Your doctor may prescribe one or more antibiotics to control and prevent brucellosis. Antibiotics are given for up to six weeks.

Surgery may be needed in patients with abscesses or an infection that does not respond to antibiotics.

Prevention

To help reduce your chances of getting brucellosis, take the following steps:

  • Avoid eating or drinking unpasteurized milk and dairy foods. If you are unsure if a dairy product is pasteurized, don’t eat it.
  • Wear rubber gloves and goggles, and securely cover open wounds when handling domesticated animals including their fluids, waste products, or carcasses.
  • Wear a protective mask when dealing with brucellosis cultures in a laboratory.
  • Have cattle and bison that live in areas heavily infected with brucellosis vaccinated by an accredited veterinarian or government health official. The vaccine contains a live virus and is dangerous to humans. For best results, calves should be vaccinated when they are 4-6 months old. There is no brucellosis vaccine for humans as of yet.
RESOURCES:

Centers for Disease Control and Prevention

http://www.cdc.gov

United States Department of Agriculture

http://www.usda.gov

CANADIAN RESOURCES:

Public Health Agency of Canada

http://www.phac-aspc.gc.ca

References:

Brucellosis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/brucellosis/. Updated November 12, 2012. Accessed August 6, 2013.

Brucellosis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated January 30, 2013. Accessed August 6, 2013.

Patel PJ, Kolawole TM, et al. Sonographic findings in scrotal brucellosis. J Clin Ultrasound. 1988;16:483-486.

Last reviewed August 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.