Brucellosis ( undulant fever , undulant fever )

 

* Brucella: bacillus gram-negative aerobic and spore forming; Brucella intracellular situation makes the total sterilization almost impossible with a risk of relapse (3-10%).

Hypersensitivity of State for chronic functional disorders.

* In animal, brucellosis is a genital disorder whose dominant expression is abortion.

* The seed won the first lymph node and multiplies it; the incubation period is 1-2 weeks.

When primoinvasion, germ wins rich organs réticulohistiocytaires cells (lymph bacteremia) nodes, liver, spleen, bone marrow, gonad.

Second period saw the development of secondary outbreaks (osteoarticular, hepatosplenic, meningeal).

During the third chronic phase torpid evolution households (osteoarticular …) and subjective clinical expression and IDR melittin + (reaction Burnet).

Sources of infection of Brucellosis

Sources of infection of Brucellosis

* Fever undulating sudoroalgique + ADP (sometimes sacroiliitis, arthritis, orchitis). 2-4 undulations succeed by periods of 15 days;

* Secondary Brucellosis: musculoskeletal locations (spondylitis, sacroiliitis) or neuromeningeal (light meningitis pseudotuberculeuse) meningoencephalitis;méningomyéloradiculite.

* The leukoneutropenia (with monocytosis) is constant during the bacteremic phase; inflammatory syndrome is modest unless suppurating home.

* Blood culture: it can be still positive in the secondary phase.

* Serum agglutination Wright: reference method.

Around the 12th or 15th day of evolution.

Persistence (Ac ≥ 1 / 80th) one year after should suggest a deep focus.

This technique has negative and false false positives (Tularemia, yer-siniose).

* Complement fixation is more specific. But late

* The response to Ag buffered (Card-test or Rose Bengal): rapid, specific, positive long; used screening.

* Bi-antibiotics: doxycycline (200mg / day) + rifampicin for 6 weeks (for acute brucellosis).

The treatment of brucellosis focused can be extended to 3 months

* Chronic brucellosis afocal derives no benefit from antibiotics.

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