Definition

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

Causes

Brucellosis is caused by specific bacteria that 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 unpasteurized dairy products
• Eating undercooked meat products
• Living in or travel to high-risk areas

Symptoms

Symptoms of brucellosis usually appear within 2 weeks of infection. Symptoms can appear from 5 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 2 days to 2 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

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

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your body fluids may need to be tested. This can be done with:

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

Pictures may be needed of your body structures. This can be done with:

• X-ray
• CT scan
• MRI scan

Treatment

Many people 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:

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 consume 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.

United States Department of Agriculture http://www.usda.gov

Public Health Agency of Canada http://www.phac-aspc.gc.ca

Brucellosis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated March 14, 2015. Accessed June 9, 2015.

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