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==pathogen==
*''Brucella aboutus''
**cattle
**Africa, temperate zone
*''B. melitensis''
**goats, sheep, camels
**Mediterranean, Middle East, Americas
*''B. suis''
**pigs, reindeer, rodents
**USA and everywhere
*''B. canis''
**dogs
*gram negative cocco-bacilli
*facultative intracellular bacteria
**prefers macrophage and reticuloendothelial system cells
***reason why brucellosis shows undulating long period course as well as potential of relapse
**also infectable in various cells including bones and joints
==epidemiology==
*estimated > 500,000 human cases per year
==clinical features==
*transmission
**ingestion of contaminated unpasteurised milk, soft cheese, natural cheese
**aspiration of infected dust
***farmers and vets higher risk
**animal contact
**human-to-human extremely rare
*incubation 1 week to weeks to months
*HIV not risk factor
*flu-like illness
**fever undulating and lasts for weeks
**night sweats
**dry cough
*myalgia and arthralgia
**difficulty walking
*depressive, anorexic, lethargy
*hepatosplenomegaly
*septic arthritis
*muscle abscess - psoas etc.
*orchitis
*low grade meningoencephalitis
*endocarditis (1%)
===difference in spp.===
*''B. abortus''
**insidious slow onset
**axial skelton
*''B. melitensis''
**acute onset
**peripheral joints
**single joint in children
*''B. suis''
**acute onset
**deep tissue abscess
==diagnosis==
*blood culture
**in short time to 3 weeks
**quite low sensitivity
*bone marrow culture more sensitive
*standard agglutination test (SAT)
*microagglutination test (MAT)
==treatment==
*relapse possible
*combination of 2 antibiotics for 3 months needed
*doxycycline + gentamycin/rifampcin
==prevention==
*one health approach
*pasteurization of milk
*animal vaccination
