4. Pathogenesis
• Inoculation in skin ,Eye
(Through abrasion or
conjunctiva)
• Inhalation
(Infected aerosol)
• Ingestion
(Meat, Dairy products)
Risk of infection depends
1. Nutritional status
2. Immune status
3. Rout of inoculum
4. Species of brucella
5. Pathogenesis
• Survive& Replicate within phagocytes&Monocytes
• Infected macrophages localized within reticuloendothelial
system(Granuloma formation in spleen,liver,bone
marrow)
6. Clinical manifestation
Triad: Fever, Arthralgia/Arthritis,Hepatosplenomegaly
• + History of animal or food
exposure
• Acute or insidious
symptoms(2-4 wk after
inoculation)
• Refusal to eat
• Refusal to bear weight
• Lassitude
• FTT
• Headache
• Inattention/Depression
• Abdominal pain
• Headache
• Diarrhea
• Rash
• Night sweets
• Weakness
• Fatigue
• Cough
• Vomiting
• Pharyngitis
8. Diagnosis
• WBC Normal or low
• + History of animal or food exposure
• Recovering organisms (blood’ bone
marrow’..)
• Serum agglutination test: >1/160
(Antibody against Abortus ,Melitensis, Suis, but not Canis)
• 2ME
9. • False positive SAT
Yersinia entrocolitica
Vibrio cholerae
Francislla tularensis
• False negative SAT
Prozen effect
18. At risk of complications
• Impaired immune function(T-Cell)
• HIV infection
• Organ transplantation
• Lymphoproliferative diseases
• Hemoglobinopathies
(Sickle cell disease’..)
• CGD
• Malaria
• Very old or very young
21. Treatment
• Correction of shock’ dehydration’…
• Antibiotics:
1-Infants < 3 mo.
2-Child with immunodeficiency’ Malnutrition
Malignancy’ Intravascular catheter or
other foreign material
22. Treatment
• Ceftriaxone or Cefotaxime
Septicemia’ Enteric fever’ Metastatic site of infection
• Amoxicillin
• Co-trimaxozole
• Fluroqinolones
• Chloramphenicol