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Brucellosis is a “stealth” zoonotic disease due to its insidious onset and persistence. Several spp. can infect humans. They are highly infectious and are categorized as group B biologic weapons. The exact pathophysiology of the disease remains to be elucidated. The epidemiologies of brucellosis differ between regions of endemicity and nonendemicity; the disease occurs among the general community in the former region and in the professional community in the latter region. The multisystem involvement and complications in adults and children and the protean or unusual clinical presentation of the disease masquerade as a wide spectrum of other infectious and noninfectious diseases, causing the disease to merit its label as “the disease of mistakes.” Such difficulty in diagnosing the disease can lead to protracted chronicity and serious complications. Thus, awareness about this disease and the proper use of laboratory resources are indispensable assets in reaching or confirming the diagnosis. Several brucella-specific assays, including conventional and instrument-utilizing culture, serologic tests, and molecular tests, are available. The proper utility and interpretation of these test results during the different presentations and phases of the disease are key factors in making an accurate diagnosis. Handling of the organism for identification to the species level, typing, and susceptibility testing requires high caution in specialized labs. The development of a safe and effective human vaccine is still being sought. The pathogen remains highly susceptible to treatment with doxycycline, rifampicin, gentamicin, and streptomycin. Dual regimens should be used, and the duration of treatment is usually long, depending on the severity of infection and the complications of the disease.

Citation: Araj G. 2015. *, p 863-872. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch47
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on blood agar (A) and Mueller-Hinton agar (B) after 48 h of growth. doi:1128/9781555817381.ch47.f1

Citation: Araj G. 2015. *, p 863-872. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch47
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Citation: Araj G. 2015. *, p 863-872. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch47
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Generic image for table

Tests commonly used in the laboratory diagnosis of brucellosis

Citation: Araj G. 2015. *, p 863-872. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch47
Generic image for table

Interpretation of commonly used serologic tests based on the immunoglobulin type detected and usefulness in the diagnosis of different disease categories/stages of human brucellosis

Citation: Araj G. 2015. *, p 863-872. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch47

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