Brucellosis

Introduction to brucellosis Brucellosis, also known as wavy heat, is an infectious disease caused by Brucella. Its clinical features are long-term fever, hyperhidrosis, joint pain, orchitis, hepatosplenomegaly, etc. The pathogen is Gram-negative bacillus, divided into Maltese Brucella (sheep type) and abortive cloth according to biochemical and serological reactions. Lu (bacteria), pig Brucella (porcine), in addition to forest mouse type, sheep epididymis type and canine type, mainly infected with sheep, cattle and pigs. Its pathogenicity is the strongest in sheep type, the second is pig type, and the cow type is the weakest. The source of infection is diseased sheep, cattle, pigs, pathogens present in the tissues of sick animals, urine, milk, birth canal secretions, amniotic fluid, placenta and sheep cover. Contact infection, but also through digestion, respiratory infection. basic knowledge The proportion of illness: 0.0030% Susceptible people: no specific population Mode of infection: respiratory transmission Complications: Neuritis Cholecystitis

Cause of brucellosis

Brucella infection (90%)

Brucella first infects livestock, and the clinical manifestations of livestock are not obvious, but the pregnant female animal is very likely to cause miscarriage or stillbirth. The discharged amniotic fluid, placenta and secretion contain a large amount of Brucella, especially infectious, and its fur, Urine feces, milk in the bacteria, the bacteria can be used for more than three months, people through the contact with livestock, taking contaminated milk and livestock meat, inhaled bacteria-containing dust or bacteria into the eye-binding membrane, etc. , can all be infected.

Pathogenesis

1. Source of infection: sheep are the main source of infection in China, followed by cattle and pigs.

2. Infection route: The herdsmen take the lamb as the main route of infection, and the veterinarian is also very susceptible to infection for sick animals. In addition, peeling cattle and sheepskin, shearing wool, milking, cutting virus meat, slaughtering sick animals, children playing sheep, etc. can be infected, and the bacteria enter the human body from the damaged skin at the contact. Laboratory workers can often infect bacteria with skin and mucous membranes. When eating raw milk, dairy products, and unboiled sick meat, the bacteria can enter the body from the digestive tract. In addition, the bacteria can also be infected through the respiratory mucosa, conjunctiva and sexual organ mucosa.

3. Susceptible population: The population is generally susceptible to Brucella.

Brucellosis prevention

1. Manage the source of infection

Strengthen the management of sick animals and find that the affected animals should be segregated in the special pastures. The aborted tire covers should be filled with lime. The affected people should be isolated in time to disappear the symptoms, blood and urine cultures are positive, and the patient's excreta and pollutants should be given. disinfection.

2. Cut off the route of transmission

The milk, meat and fur of the infected area must be strictly disinfected and sterilized before they can be transported out to protect the water source.

Brucellosis complications Complications, neuritis, cholecystitis

Complications are rare, but can infect the heart, brain and meninges, as well as inflammation of the nerves, testes, gallbladder, liver and bone. Chronic cases usually lead to long-term ill health, but this disease is rarely caused by death.

Brucellosis symptoms Common symptoms Neuralgia Hepatosplenomegaly Lymph node enlargement Irregular hot fatigue Low fever joint pain

1. Acute phase

1 The onset is slow, with prominent manifestations of chills, fever, and sweating. The average fever is 2 to 3 weeks. After several days to 2 weeks, the trend is again undulating. The heat type is mostly relaxation heat, and it can also be irregular. Heat, often due to sweating and soaking clothes, and accompanied by heat retreat, is another prominent feature of this disease.

2 joint pain, mainly for large joints, is migratory, a few with joint redness, or muscle pain.

3 lymph nodes and hepatosplenomegaly, lymphadenopathy is mainly seen in the neck and underarms.

4 other, male may have orchitis or epididymitis, women may have oophoritis, pregnant women may have miscarriage, lumbosacral neuropathy, causing sciatica is also more common.

2, chronic phase

It can be developed from the acute phase, or it has no acute history. Common symptoms include fatigue, sweating, headache, low fever, depression, irritability, and muscle and joint pain.

The incidence of epidemiology is more in spring and summer, and the incidence rate in pastoral areas is high. It is helpful to know the situation in the area, occupation, and contact range.

Examination of brucellosis

(1) Blood image: The white blood cell count is normal or low, and the lymphocytes are relatively increased.

(2) bacteriological examination: blood, bone marrow, urine can be cultured, early blood, bone marrow culture positive can reach 70% to 80%.

(3) Serological examination:

1 serum agglutination test, the course of disease can be positive for more than 2 weeks, the titer is more than 1:100, and the titer of the two determinations is doubled, which is helpful for diagnosis.

2 complement fixation test, the titer is positive above 1:10.

3 anti-human globulin test, titer > 1:80 is positive.

4 Intradermal test, 0.1 ml of brucellin was injected into the forearm skin, and the local mass of more than 2.5×2.5 cm was positive for 24 to 48 hours.

5 fluorescent antibody assays are also applicable.

Diagnosis and identification of brucellosis

Differential diagnosis

1 suppurative spondylitis: acute onset, high fever is not intermittent, systemic poisoning symptoms, white blood cells total up to 20,000 / mm3 and more neutrophils, blood culture positive, paraspinal abscess or axillary abscess Early, the bacteriological examination of the extracted pus can confirm the diagnosis, and the bone destruction on the X-ray is more than repair.

2 spinal tuberculosis: slow onset, low fever, night sweats, no other joint pain, rapid blood sedimentation, tuberculin skin test is strongly positive, X-ray changes to osteoporosis and destruction, rarely hyperplasia, late to the spine A kyphosis.

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