Diagnosis - CLINICAL - Brucellosis should be suspected In any pdlianl with prolonged pyraxia, musculoskaletal pains and a. alghtly enlarged llrm splea

Diagnosis - CLINICAL - Brucellosis should be suspected In any pdlianl with prolonged pyraxia, musculoskaletal pains and a. alghtly enlarged llrm spleain especlally it there is htstory of Consumption of raw mik' or milk products, or occupational exposure to Iniecled animals ISOLATION OF THE ORGAN ISM -(a) Blood culture - positive In more than half the patients in acute phase of 6 melftensls - Intection. usually by about 14 days (b) Culture of bone marrow aspirate, liver or lymph gland trssue culture (c) Serology - Rising Hires suggeat acute InlaCtion. but nagatlva serolcgy may be found in patients With positive blood culture (i) Standard aggluilnation testl - IgM anilbod production is associated with acuta infections Peak tires are reached 4-6 weeks after infection (ii) 2-mercaptoethanol leal • Rising titre In acute cases (iii) Anil-human globulin test (AHG lesi) - uselul in chronic brucelloss when aggkJllnation tires are negative or low, and for recurrent cfeease. (iv) Padolmmunocesay and enzyme-linked immunosorbenl assay used lor indivdual classes ofantibodies IMAGING - Isotope scanning with techneilum diatecis vertebral and perpheral joint Involvement before radologtal cfiangea OTHER TESTS - (i) Anemia, normochramic, nonmocytic (ii) Normal leucocyte counl with lymphocylosis (ii] Liver function tests may be abnonnal wilh mild elevation of aminoiranslerages and more marked elevation of alkaline phosphalaser suggesting presence of portal iract granuioma. (iv) CSF - Elavallon ol protein with lymphocyte pleocytoals Treatment -Telracycline 2-3 g/day in 4 divided doses lor about 3 weeks In oase of lallure ol response or relapse -Doxlcycline 200mg/day with Sireptomycln Other uselul chigs ara Rrtamplcln 600 rrg/day wllh letracycline or co-Trtmoxsazola, chlorarrphenlcof (i) neurological involvement), cefotaxime. fluonnated quinolna denvatives with streptonYcin 1 gnVday IMr or GenfanKin 6 mg/kg IM for first 2-3 weeks of a 6-week course Chemotharapy is given to suppress exacerbations in acute and subacute infection In chronic inlection treatment is aymptomatic Prevention - 1 Pasteurzatian or boiling of milk 2 Vaccinalion of female cafvas 3 Slaughter of