Diagnosis and treatment of 106 cases of human brucellosis

Shehabi, Asem A.; Shakir, Kandil; El‐Khateeb, Mohammed; Qubain, H.; Fararjeh, Nail; Shamat, Abdul Raouf Abu

doi:10.1016/s0163-4453(90)92214-6

Cited by 48 publications

(29 citation statements)

References 5 publications

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“…The largest of these was the already-mentioned study by Lubani et al [30], with positive results in children. Few other studies have been published [51] and only in small numbers of patients. The risk of inducing resistance of tuberculosis to rifampicin is likely to have curbed the implementation of such studies.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

Pozo¹,

2012

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BackgroundBrucellosis is a persistent health problem in many developing countries throughout the world, and the search for simple and effective treatment continues to be of great importance.Methods and FindingsA search was conducted in MEDLINE and in the Cochrane Central Register of Controlled Trials (CENTRAL). Clinical trials published from 1985 to present that assess different antimicrobial regimens in cases of documented acute uncomplicated human brucellosis were included. The primary outcomes were relapse, therapeutic failure, combined variable of relapse and therapeutic failure, and adverse effect rates. A meta-analysis with a fixed effect model was performed and odds ratio with 95% confidence intervals were calculated. A random effect model was used when significant heterogeneity between studies was verified.Comparison of combined doxycycline and rifampicin with a combination of doxycycline and streptomycin favors the latter regimen (OR = 3.17; CI95% = 2.05–4.91). There were no significant differences between combined doxycycline-streptomycin and combined doxycycline-gentamicin (OR = 1.89; CI95% = 0.81–4.39). Treatment with rifampicin and quinolones was similar to combined doxycycline-rifampicin (OR = 1.23; CI95% = 0.63–2.40). Only one study assessed triple therapy with aminoglycoside-doxycycline-rifampicin and only included patients with uncomplicated brucellosis. Thus this approach cannot be considered the therapy of choice until further studies have been performed. Combined doxycycline/co-trimoxazole or doxycycline monotherapy could represent a cost-effective alternative in certain patient groups, and further studies are needed in the future.ConclusionsAlthough the preferred treatment in uncomplicated human brucellosis is doxycycline-aminoglycoside combination, other treatments based on oral regimens or monotherapy should not be rejected until they are better studied. Triple therapy should not be considered the current treatment of choice.

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Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

Pozo¹,

2012

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“…The modern automated blood culture systems have somewhat improved the speed of detection. Although bone marrow cultures are considered the gold standard in some studies (Gotuzzo et al 1986;Mantur et al 2008a), results have not been universally reproducible (Shehabi et al 1990). In such cases, bacteremia might also be maintained from other sources of the reticulo-endothelial system (Mantur et al 2008a,b).…”

Section: Laboratory Diagnosismentioning

confidence: 99%

Brucellosis in India — a review

2008

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Brucellosis is an important re-emerging zoonosis with a worldwide distribution. It is still an uncontrolled serious public health problem in many developing countries including India. Brucellosis in India is yet a very common but often neglected disease. Currently, Brucella melitensis accounts for most recorded cases globally with cattle emerging as a important reservoir with the few cases of B. suis. Isolated cases of non-terrestrial brucellosis and continuing transmission from wild animals have raised important epidemiological issues. Routine serological surveillance along with high clinical suspicion and screening of family members of index cases would be essential in delineating the real magnitude of human brucellosis in endemic countries. Increased business and leisure travel to endemic countries have led to diagnostic challenge in non-endemic areas. Laboratory testing is indispensable for diagnosis. Advances in newer rapid, sensitive, and specific testing methodologies and alternate treatment strategies are urgently needed. A safe and effective vaccine in human is not yet available. Prevention is dependent upon increasing public awareness through health education programmes and safe livestock practices. Active co-operation between health and veterinary services should be promoted. This review collates world literature and its impact to the discovery, isolation and diagnosis and epidemiology along with the control measures adapted in the Indian scenario.

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“…usually have signs and symptoms consistent with an influenzalike or septicemic illness, often with insidious onset. The symptoms and clinical signs most commonly reported are fever, fatigue, malaise, chills, sweats, headaches, myalgia, arthralgia, and weight loss (8,10,17,18). Fewer than 10% of human cases of brucellosis may be recognized and reported (19), likely because of this misleading clinical picture (2,8).…”

mentioning

confidence: 99%

Time-Space Clustering of Human Brucellosis, California, 1973–1992 1

Fosgate

Carpenter

Chomel

et al. 2002

Emerg. Infect. Dis.

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Infection with Brucella spp. continues to pose a human health risk in California despite great strides in eradicating the disease from domestic animals. Clustering of human cases in time and space has important public health implications for understanding risk factors and sources of infection. Temporal-spatial clustering of human brucellosis in California for the 20-year period 1973–1992 was evaluated by the Ederer-Myers-Mantel, Moran’s I, and population-adjusted Moran’s I procedures. Cases were clustered in concentrated agricultural regions in the first 5-year interval (1973–1977). Time-space clustering of human brucellosis cases in California late in the 20-year study period may reflect the distribution of Hispanic populations. Public health programs in California should focus on educating Hispanic populations about the risk of consuming dairy products, such as soft cheeses, made from unpasteurized milk.

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Diagnosis and treatment of 106 cases of human brucellosis

Cited by 48 publications

References 5 publications

Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

Brucellosis in India — a review

Time-Space Clustering of Human Brucellosis, California, 1973–1992 1

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