Symptoms of brucellosis and methods of treating infectious pathology

Brucellosis is a severe infection caused by specific bacteria of the genus Brucella, the source of which is domestic animals (zoonotic infection) and multiple routes of transmission. Today, cases of brucellosis are reported throughout the world, with higher incidence in countries with developed livestock production.

Causes of brucellosis

The disease is caused by specific bacteria that belong to a separate genus, Brucella, which has 7 species. In humans, the disease is caused by 3 species - B. melitetnsis (also often causes disease in goats), B. suis (can develop in pigs) and B.

abortus (found in cattle). These bacteria are small in size and polymorphic - rod-shaped, spherical (cocci) and convoluted forms are found. They do not form spores or capsules.

Brucella has a number of features, which are called aggression factors and contribute to the development of the disease in humans and animals, these include:

• Hyaluronidase synthesis is a specific enzyme that breaks down hyaluronic acid in the intercellular substance, which facilitates the penetration of bacteria into the human body and their spread within it.
• The release of substances that inhibit (inhibit) the phagocytic activity of macrophage leukocytes - this makes it possible for intracellular parasitism of bacteria inside the cells of the immune system and a long-term course of the infectious process in the human body.
• The ability to allergize the human body due to the release of protein substances and metabolic products of bacterial cells.
• The release of a powerful endotoxin during the death and destruction of bacterial cells - it causes severe intoxication of the human body and metabolic disorders in it.
• The formation of special L- and S-forms of bacteria that are resistant to antibiotics and human immunity due to changes in their genetic structure.

These features (aggression factors) of Brucella determine the course of the disease and the mechanism of its development (pathogenesis). The most virulent (the ability to cause severe disease) is the type of bacterium - B. melitetnsis.

All bacteria that cause brucellosis are quite stable in the environment; in food (meat, milk), skin and fur of animals, they can remain viable for a long time (from several months to six months or longer).

Boiling in water kills them instantly; they are also sensitive to antiseptic solutions (hydrogen peroxide, alcohol, furatsilin, bleach, chloramine).

Epidemiology of the disease and routes of transmission

Brucellosis is a zoonotic infection. This means that the main reservoir and source of infection are animals. Humans become infected from domestic farm animals, namely goats, cows and cattle. Brucellosis is an infectious disease with several possible routes of transmission:

• The nutritional route is the most common route of transmission of infection, in which the pathogen enters the human body with contaminated food products of animal origin (meat, milk, cheese). Especially if these products are consumed raw or insufficiently thermally processed.
• Contact route - human infection occurs when his skin or mucous membranes come into direct contact with a sick animal while caring for it, delivering a baby on livestock farms or individual farms. Also, such infection is possible during the slaughter of a sick animal, cutting up its carcass, processing the skin and skins of sick animals after their slaughter.
• Aerogenic route - the pathogen enters the human body with inhaled air. This transmission route occurs when breathing air contaminated with dust or microscopic particles of hair and epidermis of sick animals.

Taking into account the peculiarities of the epidemiology of brucellosis, the source of infection, and its routes of transmission, this pathology is characterized by a higher incidence in people working on livestock farms or running individual farms.

Typically, the appearance of cases of brucellosis among humans is preceded by an epizootic (surge in incidence) of this infection among animals. During illness, a person remains non-infectious to those around him.

Several cases of infection with brucellosis in laboratory conditions, during the cultivation of bacterial cultures on nutrient media in order to identify and identify the pathogen, have also been described.

The mechanism of development of brucellosis

The entrance gates (the place of introduction of the pathogen into the body), depending on the route of transmission, are the mucous membranes of the digestive tract (stomach or intestines), respiratory system organs, skin and visible mucous membranes (eyes, oral cavity).

In the area where bacteria invade, inflammatory changes do not develop. Bacteria, as an agent foreign to the body, are captured by cells of the immune system (neutrophils and macrophages) and spread throughout the body.

Then they settle in the lymphoid tissue and give rise to the development of several pathogenetic phases of the disease, which include:

• The phase of lymphogenous introduction is the entry of Brucella bacteria into the lymphoid tissue (lymphocytes, spleen) with their active reproduction.
• Primary generalization (toxic-septic phase) - characterized by a massive release of bacteria from the lymphoid tissue into the blood. This phase coincides with the onset of clinical manifestations of the disease, since the circulation of Brucella in the blood leads to severe intoxication and allergization of the body.
• Dissemination phase - bacteria are carried through the bloodstream throughout the body and settle in a variety of organs. Favorite places for their localization are the liver, lymph nodes (re-entry), spleen, red bone marrow. In places of secondary reproduction after dissemination (spread in the body), foci of necrosis (cell death) and inflammatory reaction in the form of granulomas develop.

Subsequently, in the absence of treatment and sufficient adaptive capabilities of the human body and the functional activity of the immune system, partial suppression of bacterial growth occurs and the infection becomes chronic.

Foci of infection with a good immune response and the body's protective abilities are surrounded by connective tissue and seep in with calcium salts, which makes it possible to limit the infectious process.

To brucellosis in a person, after suffering from the disease, a stable species-specific immunity is formed - immunity to re-infection.

Symptoms of brucellosis

The incubation period (the period of time from the moment of infection to the appearance of the first clinical manifestations of the disease) for brucellosis is about 1-2 weeks. There are 3 clinical forms of brucellosis, which have their own characteristics of disease manifestations - acute, chronic and residual brucellosis.

Symptoms of acute brucellosis

Acute brucellosis is characterized by a pronounced course with manifestations of general intoxication of the body and a process duration of up to 3 months. The main symptoms of this clinical form are:

• Severe fever with a long course and high body temperature (38-40º C).
• There is no correlation between high temperature and the well-being of a sick person - even with very high numbers, the patient may feel relatively well.
• Fever is prolonged with periods of temperature decreasing to subfebrile levels (37.5º C) or to normal values. Then, after a short period of time, the fever returns - undulating fever.
• An enlarged spleen and liver, in which active proliferation of brucellosis bacteria occurs, is a hepatolienal symptom.
• The development of severe sweating, which intensifies during a period of decreased body temperature.
• Nonspecific symptoms of general intoxication are headache, malaise, weakness, loss of appetite, aches in muscles and joints. These manifestations do not depend on body temperature and can develop even at its normal value.
• Moderate hypotension (decrease in systemic blood pressure) due to intoxication of the body.

The severity of symptoms of acute brucellosis depends on the reactivity of the human body and the number of bacteria that have entered it.

Symptoms of chronic brucellosis

The chronic course of the disease is characterized by focal damage to organs in which bacteria multiply. The main symptoms of this form of brucellosis are:

• Periodic fever with a temperature of about 38º C, but more often it remains within the subfebrile range (37.5º C).
• Generalized lymphadenopathy – enlargement of all groups of lymph nodes.
• Symptoms of damage to the autonomic nervous system are increased sweating, emotional lability (mood changes over a short period of time).
• Signs of damage to the musculoskeletal system are the most common symptom of chronic brucellosis, which is characterized by unilateral inflammation of large joints (arthritis) - the hip, knee, elbow and shoulder joints.
• Infectious myocarditis is an inflammation of the heart muscle, manifested by periodic pain in the heart, not associated with physical activity.
• Long-term enlargement of the liver and spleen (hepatosplenomegaly).

In the case of severe dissemination of bacteria, various focal symptoms may develop - an inflammatory process in the eyes, genitourinary organs, muscles and skin in the form of painful dense formations.

Symptoms of residual brucellosis

Symptoms of damage to internal organs, heart, blood vessels and large joints develop, even after the body is freed from brucellosis bacteria. These changes are persistent and can persist throughout the subsequent life of the person who has recovered from the disease. Residual brucellosis is a kind of complication of a past infection.

Diagnostics

For the specific diagnosis of brucellosis, laboratory research methods are used, which include:

• Bacteriological study with the isolation of a bacterial culture of the pathogen and their identification.
• Serological diagnosis is the most common diagnostic method, in which, using various techniques (agglutination reaction, enzyme-linked immunosorbent assay), an increase in antibody titer to certain types of Brucella is detected.

For additional diagnostics, in order to determine the severity and localization of structural changes in organs, a clinical analysis of blood and urine, X-ray and ultrasound methods of instrumental examination are used. The basis for making a final diagnosis is the identification and isolation of the pathogen or antibodies to it.

Treatment of brucellosis

A set of therapeutic measures in the case of brucellosis is performed only in a medical hospital and includes:

• Etiotropic therapy is aimed at destroying the pathogen using antibacterial agents. For this purpose, antibiotics of the tetracycline and rifampicin groups are used together for a long course, at least 6 weeks, to completely destroy the pathogen and prevent the formation of resistant forms of bacteria and the development of chronic brucellosis.
• Pathogenetic therapy - necessary to reduce the severity of damage to internal organs when bacteria develop in them, includes detoxification (intravenous drip administration of saline solutions and special sorbents), antiallergic treatment with antihistamines, vitamins, immune system stimulants, painkillers (analgesics) and sedatives .

After treatment, discharge from the hospital is carried out no earlier than 2 weeks after normalization of body temperature and the absence of laboratory and clinical signs of the disease. After this, sanatorium-resort treatment is recommended.

Prevention of brucellosis

Prevention is aimed at preventing human infection with Brucella or creating immunity to bacteria entering the body (immunity). For this, 2 types of events are used:

• Nonspecific prevention - identification and isolation of sick animals at livestock enterprises, bacteriological control of food of animal origin, provision of personnel with personal protective equipment (respirators or masks, gloves, gowns).
• Specific prevention is aimed at creating immunity in people living in areas unfavorable with respect to brucellosis and livestock workers. This is done by inoculation with a vaccine containing live weakened bacteria of the 3 main types of Brucella.

The incidence of brucellosis today remains at a fairly high level. Cases of Brucella infection are constantly being reported throughout the world. This occurs more often in countries with developed livestock farming activities. Taking into account the severity of the pathology with frequent transition to a chronic form, the main direction in the fight against infection is its prevention.

Source: https://bezboleznej.ru/brucellez

Brucellosis: what is it, symptoms in humans, treatment, diagnosis

Brucellosis is a disease characterized by damage to the musculoskeletal system, nervous, reproductive and other systems. The classic environment for the circulation of pathogens is domestic animals (cows, goats, horses, less often pigs). There are several types of Brucella that primarily affect each species of these animals.

What is brucellosis?

What it is? Brucellosis is an infectious disease that is transmitted from animals to humans. Infection with brucellosis is characterized by increased proliferation of bacteria in the human body and activation of the human immune system, which together causes serious damage to the musculoskeletal, cardiovascular, nervous, respiratory, reproductive and many other systems and organs.

Having penetrated the body, Brucella quickly spreads throughout the body through lymphatic channels and blood vessels. Soon, new foci of infection appear in the liver, spleen, bone marrow, and lymph nodes. At the same time, they can cause many complications, which ultimately can lead to rather sad consequences.

The causative agent of brucellosis

The causative agents are aerobic and microaerophilic non-motile gram-negative bacteria of the genus Brucella. According to the international classification, the genus Brucella consists of 6 independent species, which are divided into a number of biovars.

After the pathogen that causes brucellosis enters the body, symptoms in a person appear within 5 to 30 days (on average, 2-3 weeks); with latent carriage, it can extend up to 3 months.

Brucella is highly invasive and can penetrate intact mucous membranes; They are classified as intracellular parasites, but they can also be found outside the cell. Brucella is quite stable in the external environment.

Brucella can survive:

• In water – up to 2 months.
• In raw meat – up to 3 months.
• In animal fur - up to 4 months.
• At a temperature of 60 degrees – up to 30 minutes.

When boiling, these microorganisms die almost instantly, just as when exposed to various disinfectant solutions (0.2 - 1% solution of bleach, chloramine, and so on).

Causes

The main source and reservoir of infection are sheep, goats, cattle and pigs. There have been cases of human infection with brucellosis from reindeer. In rare cases, the source of infection can be horses, camels, yaks and some other animals that excrete the pathogen in milk, urine, feces, and amniotic fluid.

With brucellosis, there is a clear seasonality of the disease, characterized by a winter-spring rise associated with the period of lambing, calving, and farrowing. However, brucellosis can occur throughout the year.

The possibility of transmission of infection from a sick person to a healthy person is rejected, and there are also no hospital-acquired brucellosis diseases.

Human infection with brucellosis occurs in the following ways:

• When consuming milk and meat of infected animals, or containing viable brucellosis pathogens;
• In case of contact with human skin, brucella from the wool of cattle;
• When Brucella is inhaled with dust or wool particles.

Symptoms of brucellosis in humans and photos

Brucellosis occurs when 10 microbes enter the body. The gates of infection are microtraumas of the skin, mucous membranes of the digestive organs and respiratory tract. No changes develop at the site of the infection gate. Brucella reaches the lymph nodes through the lymphatic ducts.

Reproduction and accumulation of microbes during brucellosis occurs mainly in the lymph nodes, from which brucellae periodically enter the blood.

Symptoms of brucellosis largely depend on the stage of its development, on the state of the person’s immune system, as well as on the dose of the pathogen that initially entered the body (the higher it is, the faster and more pronounced the clinical manifestations of the disease will appear).

It is also worth noting that most severe forms of brucellosis are caused by B. melitensis, which humans can contract from small livestock.

Common symptoms of brucellosis:

• headache;
• muscle pain;
• joint and lower back pain;
• elevated temperature;
• bowel dysfunction (diarrhea, constipation);
• weight loss;
• enlarged lymph nodes and liver;
• depression.

The incubation period for brucellosis is from 1 to 4 weeks, but can extend to 2-3 months with the development of a latent infection.

Forms and characteristic features

According to the modern clinical classification, the following forms of brucellosis are distinguished:

• acute (lasting up to 1.5 months),
• subacute (up to 4 months),
• chronic (more than 4 months),
• residual (clinic of consequences).

Acute brucellosis

The incubation period for acute onset brucellosis can last about 3 weeks, but incubation can last several months. The acute septic form is characterized by high fever (39-40°C and above).

Despite high and very high body temperature, the patient’s health remains good (at a temperature of 39°C and above, the patient can read books, play chess, watch TV, etc.). This form of brucellosis does not threaten the patient’s life; even without treatment, it ends in recovery.

Subacute form of brucellosis in humans

With subacute brucellosis, along with intoxication, signs such as focal lesions in the form of arthritis, neuritis, plexitis, etc. appear. The transition of subacute brucellosis to chronic occurs gradually and is clinically difficult to detect.

Chronic

Chronic brucellosis occurs in waves, with the manifestation of symptoms of multiple organ lesions.

In this case, the general intoxication syndrome (fever and intoxication) is usually expressed moderately, the temperature rarely exceeds subfebrile values. The intervals between exacerbations of the disease can last 1-2 months.

In the event of the formation of a new infectious focus within the body, the general condition deteriorates.

Residual brucellosis

A person who has had brucellosis may have residual effects. Various symptoms appear:

• complaints of a neurasthenic and vascular-vegetative nature,
• joint and muscle pain,
• headache.

Functional disorders persist or organic irreversible lesions of various organs and systems, especially the organs of movement and support, are formed. This is polyarthritis with irreversible deformations and subsequent contractures, muscle atrophy, spondylosis, arthrosis, ankylosis.

So, this very difficult disease is brucellosis. Symptoms in a person, photos and a general description of the state of the body, allow you to immediately calculate the infection to prevent exacerbation or transition to the chronic stage.

Diagnostics

A diagnosis of brucellosis can be suspected after a thorough interview of the patient, as well as on the basis of clinical examination data and data on the epidemiological situation in the area. In acute brucellosis, the temperature measurement schedule is incorrect, with the appearance of chills and increased sweating.

The doctor should also exclude rheumatoid arthritis and rheumatism, tuberculous focal lesions, gonorrheal and syphilitic arthritis. If brucellosis is suspected, the condition of the lymph nodes, liver and spleen is checked.

At the same time, to confirm the diagnosis it is necessary to conduct a number of laboratory tests.

Tests for brucellosis

A referral for a general blood test and bacteriological tests will be given by an infectious disease doctor as soon as he detects clear signs of the development of brucellosis.

1. General blood analysis. It is necessary to determine the content of leukocytes. If the indicator is elevated, this means that there is an inflammatory process in the body. The erythrocyte sedimentation rate (ESR) accelerates, but not by much. The advanced stage of the disease leads to a decrease in the levels of all blood elements.
2. General urine test for brucellosis. Here it is necessary to determine whether protein is present in the urine, and in what quantities. To do this, it is necessary to repeat this urine test several times.
3. Blood chemistry. Here we look at the levels of hepatic cytolysis (ALAT, AST), if these indicators become higher than normal, then we talk about hyperbilirubinemia, the level of albumin decreases (hypoalbuminemia), while the total protein remains at a normal level.

To make an accurate diagnosis, the patient is prescribed a number of tests for brucellosis in humans:

• hemagglutination aggregate reaction, which detects Brucella antigens in the blood;
• Coombs test, to detect incomplete antibodies in chronic brucellosis;
• Wright's reaction, the most informative for acute brucellosis; Brucella lysis reaction;
• Burnet test, with intradermal injection of brucellin.

To obtain the most accurate results, it is recommended to use 3-4 serological diagnostic methods simultaneously, this is called complex serodiagnosis.

Treatment of brucellosis

How and how to treat brucellosis in humans? The principles and methods of therapy depend on the form of brucellosis. Antibiotic therapy can be effective only in the acute septic (acute) form of brucellosis; in chronic forms, the prescription of antibiotics plays a supporting role; vaccine therapy is of primary importance.

Treatment of brucellosis with drugs is carried out by taking broad-spectrum antibiotics. Taking antibiotics lasts up to six months, after which a break is taken. When re-diagnosed, the effectiveness of the drugs is revealed.

Effective antibiotic drugs include:

• Gentamicin;
• Doxycycline;
• Streptomycin;
• Rifampicin.

When chronic brucellosis is diagnosed, treatment is based on the use of general strengthening measures and vaccine therapy. The prognosis in most cases is favorable, however, it is worth remembering that brucellosis often leads to disability.

Vaccine against brucellosis

The vaccine against brucellosis is carried out no later than 3-4 weeks before the start of work associated with the risk of infection (time of development of immunity), the maximum intensity lasts 5-6 months, duration - 10-12 months. Before vaccination, the specific immunity of one of the serological or skin-allergic reactions is determined. Only persons with a negative reaction are subject to vaccination.

At the same time, vaccination using it is carried out only among the population of those areas where diseases among animals are registered. Persons working on livestock farms and enterprises processing livestock products are also subject to vaccination. Vaccination provides fairly stable immunity for 1-2 years.

Vaccination is carried out in the area of ​​the outer surface of the shoulder at the border between the upper and middle third, once cutaneously or subcutaneously:

• One dose for cutaneous administration is 2 drops and contains 1-1010 microbial cells;
• When administered subcutaneously - 0.5 ml and contains 4-108 microbial cells.

Therefore, there are contraindications to the use of the vaccine. It cannot be used in the following cases:

• In the presence of immunodeficiency.
• When detecting tumors, blood diseases and in the process of treating such ailments. Under these circumstances, vaccination is possible only when six months have passed since the last course of treatment.
• At elevated temperatures.
• During pregnancy and breastfeeding.
• In the presence of chronic diseases.
• Patients with acquired immunodeficiency syndrome (AIDS) or other immunodeficiency conditions.
• For serious skin diseases.
• If there is a positive reaction to a trial vaccination.
• If there are any adverse reactions.
• If you have a history of severe allergic diseases or reactions (Quincke's edema, bronchial asthma, anaphylactic shock). In this case, the decision on the possibility of vaccination is made only after consultation with an allergist.

Prevention

Preventive measures for brucellosis are nonspecific and include combating the spread of pathogens among animals. This can be achieved through early detection, isolation and elimination of diseased individuals.

Livestock products (milk, meat, wool and hide processing) must be carefully monitored.

From consumers of meat and dairy products:

• eating pasteurized or boiled milk
• purchasing meat products that have a brand on them
• thorough heat treatment of meat and dairy products purchased second-hand

In addition, in regions considered disadvantaged in this sense, regular immunoprophylaxis of brucellosis is carried out - a live vaccine is administered. Workers at slaughterhouses and farms that keep such animals are also vaccinated. Disinfection of raw materials is the most important measure for the prevention of brucellosis, as well as pasteurization of milk and other measures.

Source: http://www.zdoroviyvopros.ru/infektsionnye-zabolevaniya/brutsellez-u-cheloveka/

Brucellosis

Brucellosis is a zoonotic infection characterized by multiple organ pathologies and a tendency to become chronic. A significant pathogenetic component of brucellosis is allergic reactivity.

Transmission of Brucella occurs mainly through food and water, most often through the milk and meat of infected animals. Among cattle breeders, airborne and contact transmission of brucellosis can occur. The diagnosis is established by identifying the pathogen in the blood, lymph node puncture or cerebrospinal fluid. Serological diagnosis can be considered reliable if the result is positive from several different methods: ELISA, RLA, RNGA, RIF, RSK, etc.

Brucellosis is a zoonotic infection characterized by multiple organ pathologies and a tendency to become chronic. A significant pathogenetic component of brucellosis is allergic reactivity.

Brucellosis is classified according to the nature of its course, distinguishing acute (duration up to one and a half months), subacute (no more than four months), chronic (more than four months) and residual (long-term consequences) forms.

Brucellosis is caused by nonmotile polymorphic gram-negative microorganisms of the genus Brucella. The type of Brucella causing the infection influences the severity of the course; the most severe course of brucellosis is caused by infection with Brucella melitensis.

Brucella are highly invasive, multiplying inside the cells of the host body, but are able to remain active outside the cell. They are stable in the environment, persisting in water for more than two months, three months in raw meat (30 days in salted meat), about two months in feta cheese and up to four months in animal wool.

Boiling is detrimental to Brucella; heating to 60 °C kills them in 30 minutes.

The reservoir of brucellosis is animals; the source of infection for humans is mainly goats, sheep, cows and pigs. In some cases, transmission from horses, camels, and some other animals is possible.

The pathogen is excreted by sick animals in feces (feces, urine), milk, and amniotic fluid.

A significant epidemiological danger is posed by milk obtained from sick animals and dairy products (cheese cheese, kumis, cheeses), meat, and products made from animal raw materials (wool, leather).

Animals contaminate soil, water, and feed with feces, which can also contribute to human infection through non-food routes.

Contact-household and airborne dust paths are realized when caring for animals and processing animal raw materials.

With brucellosis in pregnant women, there is a possibility of intrauterine transmission of the infection, in addition, postnatal transmission during lactation is possible. People are highly susceptible to brucellosis; after infection, immunity remains for 6-9 months. Re-infection with Brucella occurs in 2-7% of cases.

The incubation period of brucellosis is on average 1-4 weeks, but with the formation of latent carriage it extends to 2-3 months.

Acute brucellosis usually develops quickly; in elderly people, the onset can be gradual (in this case, patients note prodromal phenomena in the form of general malaise, insomnia, weakness, arthralgia and myalgia with a gradual increase in intoxication over several days).

The body temperature rises sharply to high numbers, stunning chills alternate with heavy sweat, intoxication develops, most often moderate, despite the pronounced temperature reaction.

Moderate polylymphadenopathy is detected - the lymph nodes, mainly cervical and axillary, are somewhat enlarged in size and moderately painful to the touch.

In the acute form, fibrositis and cellulitis, more characteristic of the subacute course of brucellosis, may also be observed - dense, painful formations along the tendons and muscles the size of a pea (sometimes reaching the size of a small chicken egg).

Subacute brucellosis

The subacute form of brucellosis is characterized by alternating relapses of fever with periods of normal temperature.

Feverish periods can be of varying duration, the temperature rise can range from low-grade fever to extremely high values ​​(including during the day). The fever is directional.

An increase in temperature is accompanied by signs of intoxication: pain in muscles and joints, paresthesia (tingling sensations, “pins and needles” in various parts of the body), general weakness, decreased appetite and heart rhythm disturbances (at the height of the fever, relative bradycardia occurs - a discrepancy between the rhythm frequency and body temperature). At normal temperatures, an increase in heart rate may be observed. Heart sounds are muffled. Patients feel thirsty, complain of dry mouth, and constipation is common.

This form of the disease is often accompanied by fibrosis and cellulite. In severe cases, infectious-toxic shock and complications in the form of inflammation of the membranes of the heart (pericarditis) may develop.

The subacute form of brucellosis is accompanied by manifestations of allergies - rashes, dermatitis, vascular reactions, etc.). The first thing that usually affects the articular system is reactive polyarthritis, bursitis and tendovaginitis.

Men are characterized by damage to the testicles and their appendages; women may experience menstrual irregularities and endometritis. Brucellosis during pregnancy can contribute to its premature termination.

Chronic brucellosis

It proceeds in waves, with the manifestation of symptoms of multiple organ lesions. In this case, the general intoxication syndrome (fever and intoxication) is usually expressed moderately, the temperature rarely exceeds subfebrile values.

The intervals between exacerbations of the disease can last 1-2 months. In the event of the formation of a new infectious focus within the body, the general condition deteriorates.

The symptoms of chronic brucellosis depend on the predominant damage to one or another functional system by the pathogen and the severity of the allergic component.

Patients with brucellosis often have neuritis (including inflammation of the optic and auditory nerves) and radiculitis, inflammation of the nerve plexuses, and paresthesia. A long course of the disease contributes to the development of reactive neurosis.

Chronic brucellosis is also characterized by allergic inflammation of the gonads and fertility disorders (infertility in women, impotence in men).

The duration of the disease can be 2-3 years and increases with repeated infection.

Residual brucellosis

Residual brucellosis - delayed consequences of infection - is associated with the formation of pathological reactivity. Due to the restructuring of the immunological structure of the body, specific reactions of the body are possible - low-grade body temperature, psychological deviations, pathologies of joints, connective tissue formations.

In addition, brucellosis can leave behind serious degenerative changes in fibrous tissue, especially significant in the area of ​​nerve trunks and plexuses - there is a high probability of developing contractures and the occurrence of neurological symptoms (paresis, neuropathy).

The long course of the disease contributes to the formation of persistent functional disorders of the musculoskeletal structures due to irreversible destruction of articular tissues and ligamentous apparatus (ankylosis and spondylosis, contractures, muscle atrophy).

Often, such consequences of brucellosis are an indication for surgical correction.

Bacteriological diagnostics are carried out in specialized laboratories equipped to work with pathogens of particularly dangerous infections.

Brucella is isolated from blood, cerebrospinal fluid, and lymph node punctates by inoculating biological material on nutrient media.

Due to the significant labor costs, isolation of the pathogen is rarely carried out for diagnostic purposes; determination of antigens to Brucella in the patient’s blood and serological tests are sufficient to confirm the diagnosis.

Antibodies are determined using RA, RNGA, RSK, RIF, as well as the Wright reaction and a test for the interaction of Brucella with the patient’s serum. A positive result in at least 3-4 different serological tests is considered sufficient for diagnosis.

Starting from the 20-25th day of illness and for a long period (several years) after recovery, a positive reaction to the Burnet skin test (subcutaneous injection of brucellin) is noted.

Outpatient treatment is indicated for mild infections. In case of severe course and threat of complications, hospitalization is performed. During the period of fever, patients are prescribed bed rest.

Etiotropic therapy involves the prescription of antibiotics of various groups; one of the drugs must have the ability to penetrate the cell wall.

The following antibiotic pairs are effective: rifampicin with doxycycline or ofloxacin, doxycycline with streptomycin. In case of relapse, a second course of antibiotic therapy is prescribed.

In addition to basic therapy, pathogenetic and symptomatic agents are prescribed: detoxification therapy (depending on the severity of intoxication), immunostimulating agents (bovine thymus extract, pentoxyl), novocaine blockades for spondylitis and intense radiculitis, anti-inflammatory drugs (non-steroidal drugs and corticosteroids, depending on the course and articular manifestations).

Previously, a therapeutic vaccine was used in the complex therapy of brucellosis, but this practice is currently being abandoned due to the pronounced suppression of the immune system and the ability of the vaccine to provoke autoimmune processes. During remissions, patients are recommended to undergo sanatorium-resort treatment, physiotherapy (UHF, quartz, radon baths, etc.) and physical therapy.

The complex of preventive measures aimed at reducing the incidence of brucellosis in humans includes veterinary monitoring of the health of farm animals, as well as sanitary and hygienic regulation of production conditions, storage and transportation of food products, and annual preventive examinations of agricultural workers.

Farm livestock is subject to routine vaccination. Also, specific prophylaxis through vaccination with live brucellosis vaccine is indicated for persons directly working with animals. Personal preventive measures also include special clothing for working with animal raw materials and strict adherence to personal hygiene rules.

Source: https://www.KrasotaiMedicina.ru/diseases/infectious/brucellosis

Brucellosis. Causes, signs, prevention and treatment of brucellosis

Brucellosis is a disease, a zoonotic infection that can be transmitted from infected animals to humans and is characterized by multiple lesions of body systems, human organs. The microorganisms that cause this disease were first discovered by the English scientist Bruce in 1886. In honor of him, they were called brucella, and the disease they cause was called brucellosis.

Definition of brucellosis

brucellosis photo

Brucellosis is a disease , a zoonotic infection that can be transmitted from infected animals to humans and is characterized by multiple lesions of body systems , human organs. The microorganisms that cause this disease were first discovered by the English scientist Bruce in 1886. In honor of him, they were called brucella, and the disease they cause was called brucellosis.

Brucella is extremely stable in fresh air, lives in water for more than 2 months, in meat (raw) - about 3 months, in milk - within 40 days, in wool - about 4- x months, in feta cheese – approximately 2 months, in salted meat – up to 30 days. Brucellosis bacteria die under the influence of many disinfectants and when heated.

Chronic brucellosis is a common occurrence in modern life. Brucella cannot be transmitted to a healthy person from a patient diagnosed with brucellosis. Farm animals (cows, pigs, sheep, goats, and less often dogs) are considered the source and reservoir of infection.

Infection of sick animals with humans occurs through food, air and contact methods. Infection by contact especially often occurs when amniotic fluid gets on the surface of the skin (help with lambing, calving, when caring for newborn lambs, calves).

Veterinary workers, shepherds, calves and others often have every chance of becoming infected. Infection can occur through contact with the meat of infected animals or with manure. Brucella has every chance of leaking through wounds in the skin.

Food contamination often occurs from raw milk, and also from consumption of eco-friendly dairy products (cheese, butter, feta cheese).

Airborne infection occurs when dust containing Brucella enters the respiratory tract (in sheep pens and grazing areas) and also in laboratories if the rules are not observed. security experts. This method of infection is observed relatively rarely. People of working age (17-50 years) are most often infected. As a rule, this is an occupational disease.

Prerequisites for the occurrence of brucellosis

consuming unboiled goat milk can cause illness

Brucellosis transmission routes can be very diverse, for example, the following: consumption of unboiled goat milk and other milk products.

Slaughterhouse workers, located directly in the buildings where animals are killed, get sick when inhaling evaporated liquids, contaminating damaged skin, getting microorganisms on mucous membranes.

Peasants and shepherds are similarly at risk of infection, especially through contact with dead animals.

Veterinarians have every chance of becoming infected if they handle animal vaccinations carelessly. Laboratory workers (microbiologists) can get sick when working with research materials if they do not adhere to safety rules.

Signs of brucellosis

One of the signs of the disease is severe pain in the lower extremities

When suffering from brucellosis, the incubation period can last within 1-2 weeks. Often the disease develops slowly and has no distinctive features.

• Signs of brucellosis in patients may be different:
• pain in the joints, mainly in the lower extremities, sometimes unbearable and severe - long-lasting, subfebrile, significant increase in temperature - increase in temperature of a wavy type - with falls and rises of a sharp nature - increased sweating, steam production, from time to time night sweats - unintentional weakness, sudden loss of strength.
• There are a variety of systemic lesions that can affect virtually all organs.

In the heart: myocarditis, aortic root abscess, thrombophlebitis, endocarditis, myocarditis (and on previously unchanged valves), endocarditis may develop. In the respiratory system: bronchus it pneumonia.

In the musculoskeletal system: asymmetric polyarthritis of the knee joint, myalgia of the sternoclavicular and brachial sacroilial joints, septic monoarthritis, spinal osteomyelitis chnik.

In the lymph nodes: lymphadenitis, enlarged spleen. In the eyes: endophthalmitis, uveitis, corneal ulcers, keratitis.

Diagnosis of brucellosis

laboratory tests will help identify the disease

Diagnosing brucellosis is not difficult for an experienced physician. To make a diagnosis, you need to take into account the epidemiological history, the entire symptom complex of the disease and conduct research in the laboratory. The diagnosis can be confirmed by serological and bacteriological methods.

The causative agent of brucellosis can be isolated from the brain, cerebrospinal fluid, urine, blood, as well as bone marrow, sputum and other biosubstrates (even in acute and subacute forms).

Progressive methods make it possible to isolate L-form Brucella from patients with chronic infection. However, bacteriological research methods are complex and require special conditions.

As a result, serological methods are mainly used in practice:

agglutination reactions (RA) become positive from the third day of illness and last for a long time - the study is always carried out on plates and is used in group studies of people y-RPGA and RSK, which make it possible to detect antibodies not only to ordinary ones, but also to L-form brucella, can have enormous diagnostic value for the diagnosis of both chronic and acute, erased forms - for identifying erased forms of the disease, the Coombs test with antiglobulin-b is of particular importance Today, the enzyme-linked immunosorbent test (ELISA), which is recommended as an express method for mass brucellosis examinations, is considered more susceptible. intradermal Burnet test is used to determine the degree of sensitization in the body - and the test becomes positive only from the 21-25th day of illness and persists for almost all years after le disappearance of symptoms.

Differential diagnosis can be made with malaria, rheumatism, typhoid fever, Q fever, rheumatoid arthritis, sepsis, tuberculosis, tularemia.

Treatment of brucellosis using traditional methods

Carrot-pumpkin juice will help heal from illness

Treatment with juices and fruits. 400 ml. pumpkin juice and 700 gr. mix carrot juice. Drink the mixture 3 times a day, half a glass before meals.

Cure by hunger. You will need 160 ml. water, 40 ml. carrot and citrus juice, 1 l. British salt. It is necessary to add juices to the solution and dissolve salt in boiling water, then drink this mixture every half hour. When the body is cleansed, it will be necessary to fast: drink exclusively vegetable juices for at least 3-5 days, and be sure to give enemas every evening before bed.

Treatment with water. To cure, you can take pine baths or baths with mineral water, keeping the temperature up to 34-36°C, the duration of the procedure is 5-6 minutes.

Therapeutic exercises and massage. In order to significantly improve blood circulation in the affected joints and restore their functions, therapeutic exercises and massage are often prescribed.

After these procedures, no questions arise about how to treat brucellosis.

Prevention of brucellosis

To prevent disease, animals are vaccinated multiple times

Prevention of brucellosis is not an easy task . This infectious disease can be transmitted from a sick animal to humans.

Prevention of brucellosis consists of identifying and reliable isolation of absolutely all sick animals at the first suspicion of infection. The killing of animals is carried out in specially equipped areas in compliance with the required sanitary conditions.

Animals are vaccinated repeatedly to prevent disease so that brucellosis does not spread.

The premises in which animals were kept are thoroughly disinfected with disinfectants.

In order to disinfect the skin of an animal, it must be salted for about 2 months, and the wool must be treated with methyl bromide.

To prevent the possibility of infection with this disease, dairy products are made from thermally sterilized milk, and the meat is cooked for 3 hours.

People who are in direct contact with animals (employees of tanning companies, meat processing plants) are required to use protective equipment and special clothing that are treated with chlorine solution amine or lysol. Protective equipment should include: gloves, robe, respirator, rubber boots, overalls.

Under no circumstances should pregnant women and children be allowed to work on this job. Those who work at enterprises are vaccinated every year to prevent disease.

Video: Brucellosis. How to avoid getting sick from milk?

Source: http://www.uzmed.info/zabolevaniya/prichiny-priznaki-lechenie-narodnymi-sredstvami-i-profilaktika-brucelleza.html