Facultative, intracellular, gram-negative coccobacilli; known human pathogens include Brucella abortus, B. melitensis, B. suis, and B. canis.
Most commonly through consumption of contaminated dairy products. Brucella can enter the body via skin wounds, mucous membranes, or inhalation. Person-to-person transmission is rare.
High-risk regions include the Mediterranean Basin, South and Central America, Eastern Europe, Asia, Africa, and the Middle East.
Incubation period is 2–4 weeks (range, 5 days to 5 months). Initial presentation is nonspecific, including fever, muscle aches, fatigue, headache, and night sweats.
Blood culture is the diagnostic gold standard, but is not always positive. If blood or bone marrow culture is used, the laboratory must be informed that Brucella is suspected, so that they will process the sample for a longer period of time and protect laboratory personnel. A serum agglutination test is the most common serologic approach, but other serology, ELISA, and PCR have been used to make a diagnosis.
Doxycycline, rifampin, and trimethoprim-sulfamethoxazole have been used in various combinations for treatment. Sometimes surgery is required.
Avoid unpasteurized dairy products and undercooked meat.
Ariza J, Bosilkovski M, Cascio A, Colmenero JD, Corbel MJ, Falagas ME, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med. 2007 Dec;4(12):e317.
Arnow PM, Smaron M, Ormiste V. Brucellosis in a group of travelers to Spain. JAMA. 1984 Jan 27;251(4):505–7.
Memish ZA, Balkhy HH. Brucellosis and international travel. J Travel Med. 2004 Jan–Feb;11(1):49–55.
Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006 Feb;6(2):91–9.