1/10. meningoencephalitis in brucellosis.Human brucellosis, more specifically neurobrucellosis, is a less commonly reported disease in india; although, animal brucellosis and seroprevalence in specific areas is well reported. We are reporting 4 cases of neurobrucellosis presenting as meningoencephalitis. diagnosis was confirmed by serological test and agglutination titre was > 1:320 in all the patients. All these patients had close contact with animals and history of raw milk ingestion was present in 3 cases. The aim of presenting these cases is to create awareness among physicians while treating meningitis in persons, engaged in occupations related to brucellosis or having a history of ingestion of raw milk or milk product.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/10. brucellosis in immigrants in denmark.brucellosis is a rarely encountered infection in northern europe. We report 4 cases of brucella abortus bacteremia occurring in denmark during 1999-2000. The clinical presentation was characteristically vague and brucellosis was not suspected by the attending physicians, partly because incomplete patient histories were obtained as a result of language barriers. The diagnosis was finally established by means of blood cultures, which were performed because of fever of unknown origin.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/10. Human brucellosis.BACKGROUND: Human brucellosis has a serious medical impact worldwide, and its eradication poses major difficulties. Although human brucellosis is relatively rare in the United States (approximately 100 cases per year), there is concern that this disease is largely underdiagnosed and underreported. Additionally, immigrants from endemic areas are arriving to this country, and Brucella species are considered to be biologic agents for terrorism. Human brucellosis affects all age-groups, and family physicians are not well versed in recognizing and treating this potentially life-threatening condition. methods: A literature review from 1975 to 2001 was performed using the key words "human brucellosis," "zoonosis," and "bioterrorism." RESULTS AND CONCLUSIONS: Appropriate antimicrobial therapy and duration of treatment of human brucellosis will reduce morbidity, prevent complications, and diminish relapses. Because of the nonspecific symptoms and rarity of human brucellosis in the United States, family physicians must acquire a detailed dietary and occupational history to diagnose the disease promptly. family physicians must assume a responsible role in reporting this disease, as well as be aware of persons at high-risk for this disease and the potential sources of infection.- - - - - - - - - - ranking = 3keywords = physician (Clic here for more details about this article) |
4/10. brucella suis infection in philadelphia. A survey of hog fever and asymptomatic brucellosis.Examination of hospital and public health records revealed 19 cases of brucellosis diagnosed in philadelphia between 1968 and 1972. A serologic survey at philadelphia's largest hog-processing plant, however, indicated infection in 39% of workers. If extrapolated industry-wide, the total would be several hundred in philadelphia. The infection is usually unrecognized or asymptomatic, since men were active in physically demanding jobs with agglutinin titers in excess of 1:5000. Overt illness, usually first diagnosed after weeks of incapacity, responded readily to tetracycline therapy. Although clinical manifestations are nonspecific, attention to occupational history should quickly lead to the diagnosis. It is emphasized that any hog-processing plant, wherever located, is potentially a reservoir of brucellosis. Prolonged morbidity and loss of production time might be avoided if physicians were more alert to this infection. agglutinins in possibly significant titers were also found in a small fraction of persons without identifiable exposure.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/10. An atypical case of brucellosis in a Turkish national.brucellosis is an endemic disease in many of the countries in which military personnel are stationed, including the middle east, where thousands are deployed. The signs and symptoms of brucellosis are often nonspecific and diagnosis requires a high index of suspicion. This case report involves a Turkish national with an unusual febrile illness, subsequently diagnosed as brucellosis. The presentation, diagnosis, and treatment are discussed. The special relevance to the military physician is emphasized.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/10. Brucella meningitis.A 36-year-old Hispanic man came into the emergency department with nonspecific symptoms (headache, myalgias, low-grade temperature, and low white blood cell count) and was diagnosed with brucella meningitis. The patient said he had consumed unpasteurized goat's milk and cheese in mexico, and had been treated 3 months previously for a febrile illness diagnosed as malta fever (brucellosis). Cultures of both the blood and cerebrospinal fluid yielded brucella melitensis. Blood agglutinin results for B abortus were positive at greater than 1:160. Unpasteurized milk and cheese are consumed in many countries where brucellosis is endemic. Emergency physicians are occasionally confronted with patients from developing countries with diseases that require rapid and specific diagnosis for optimal treatment.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/10. brucella canis: an infectious cause of prolonged fever of undetermined origin.We have reported a case documenting the difficulties encountered in diagnosing and treating patients with brucellosis caused by brucella canis, including the nonspecific clinical presentation, low level of intermittent bacteremias, the slow-growing, fastidious nature of the organism, and the lack of antigenic cross-reactivity with the antigens usually used in routine Brucella serology. Further, the predominant southeastern united states epidemiology of this organism and the importance of exposure to dogs are also demonstrated by this report. It is important that physicians caring for patients in this region of the country be aware of the epidemiologic, serologic, and microbiologic pitfalls encountered in diagnosing B canis infections.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/10. brucellosis in a group of travelers to spain.An epidemiologic investigation, initiated when brucella melitensis infection was detected in a high school student, identified five unrecognized cases in classmates. Before the investigation, four infected students had symptoms of brucellosis for one to ten weeks, made nine visits to physicians, and were confined to the school infirmary or hospitals for 27 days. The other two students were asymptomatic when Brucella agglutination testing demonstrated elevated titers, and treatment was quickly instituted when symptoms occurred. travel to spain was implicated because cases were clustered in six of 27 travelers compared with none of 23 control students. food-history questionnaires showed more frequent consumption of cheese by infected than noninfected travelers. This cluster of cases demonstrates the risk of brucellosis in travelers to endemic areas and illustrates the value of an epidemiologic investigation of cases.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/10. fever of unknown origin: diagnostic principles.Almost by definition, diagnostic evaluation of a patient with fever of unknown origin remains a challenging problem. Before turning to lengthy checklists and a battery of sophisticated invasive procedures, the physician should pursue all possibilities suggested by the patient's clinical and epidemiologic history. Four illustrative cases are presented to exemplify this logical approach.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/10. Spinal brucellosis in a southern california resident.Dynamic changes in patient demography that are currently altering the regional epidemiology of brucellosis attest to the need for physicians to reacquaint themselves with a disease that has been largely forgotten in the United States. This is especially the case in california, which has a large immigrant population and where brucellosis clearly appears to have evolved from an occupational to a food-borne illness. In our recent clinical experiences with several cases of brucellosis, food-borne transmission of the organism is the presumptive cause of the disease, as no causes were associated with occupational risks for exposure to the organism. This suggests that given a clinical history consistent with brucellosis, physicians working with patient groups at risk for food-borne exposure must inquire about the ingestion of unpasteurized dairy products specifically and early during the patient visit. A history of travel to areas endemic for brucellosis may further aid diagnosis. Although a predominance of nonspecific clinical signs and symptoms (such as fevers or arthralgias) often makes the clinical diagnosis difficult, the frequency and characteristic patterns of localized disease should heighten clinicians' index of suspicion and lower the threshold for a serologic investigation. Prominent musculoskeletal complaints (especially back pain) accompanied by constitutional symptoms such as fever, malaise, and weight loss may be consistent with brucellosis and a history of unpasteurized dairy ingestion should be elicited. Radiographic evidence that localizes the source of back pain as caused by sacroiliitis or spondylitis is highly suggestive of brucellosis in appropriate patients. In such cases, serologic tests should be persuaded early if warranted by the clinical impression.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
| | Next -> |