Materiały źródłowe

• #1 Laboratory Diagnosis of Human Brucellosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6860005/

  The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patients proper treatment. The diagnosis of brucellar infections can be made by culture, serological tests, and nucleic acid amplification assays. […] Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases. […] Serological tests, though they lack specificity and provide results that may be difficult to interpret in individuals repeatedly exposed to Brucella organisms, nevertheless remain a diagnostic cornerstone in resource-poor countries.

• #2 Clinical Overview of Brucellosis | Brucellosis | CDC

  https://www.cdc.gov/brucellosis/hcp/clinical-overview/index.html

  Brucellosis in people cannot be diagnosed by clinical symptoms alone as initial symptoms are non-specific and can vary between patients. Laboratory testing is required to confirm a diagnosis. […] If a patient has brucellosis symptoms, determining the route of exposure history can help you determine the right kind of laboratory testing (serology or culture, for instance). […] Most commercial clinical laboratories run serological tests that can detect antibodies to three Brucella species: B. abortus, B. melitensis, or B. suis. […] Some labs can also conduct culture tests on cerebrospinal fluid, purulent discharge, or joint fluid. […] Infection with B. canis and Brucella RB51 cannot be detected through serology testing, so labs will have to confirm the infection by these Brucellae with a culture.

• #3 Laboratory Diagnostic Procedures for Human Brucellosis: An Overview of Existing Approaches

  https://brieflands.com/articles/jjm-91200

  Diagnosis of human brucellosis still challenges clinicians and scientists with several considerable aspects, particularly in endemic countries. […] The current study aimed at reviewing laboratory tests in the diagnosis of human brucellosis. […] The article reviewed the methods for the diagnosis of human brucellosis and summarized developments for the future. […] Definitive diagnosis of brucellosis needs comprehensive evaluation of the living conditions of the patient, medical history, clinical examinations, and careful interpretation of laboratory test results and radiologic findings. […] Indeed, diagnosis of brucellosis is frequently delayed and often missed especially in the developing countries. […] The gold standard for diagnosis still is bacterial culture, which often fails. Thus, diagnosis relies on the combination of several methods.

• #4 Microbiological Laboratory Diagnosis of Human Brucellosis: An Overview

  https://www.mdpi.com/2076-0817/10/12/1623

  Brucella spp. are Gram-negative, non-motile, non-spore-forming, slow-growing, facultative intracellular bacteria causing brucellosis. […] A microbiological analysis is crucial to identifying human cases because clinical symptoms of human brucellosis are variable and aspecific. The laboratory diagnosis is based on three different microbiological approaches: (i) direct diagnosis by culture, (ii) indirect diagnosis by serological tests, and (iii) direct rapid diagnosis by molecular PCR-based methods. […] Despite the established experience with serological tests and highly sensitive nucleic acid amplification tests (NAATs), a culture is still considered the “gold standard” in the laboratory diagnosis of brucellosis due to its clinical and epidemiological relevance. […] The main limitations of serological tests are the lack of common interpretative criteria, the suboptimal specificity due to interspecies cross-reactivity, and the low sensitivity during the early stage of disease.

• #5 Microbiological Laboratory Diagnosis of Human Brucellosis: An Overview

  https://www.mdpi.com/2076-0817/10/12/1623

  NAATs are rapid tests that can help diagnose brucellosis in a few hours with high sensitivity and specificity. […] The fast and precise diagnosis of human brucellosis is essential for the delivery of a prompt and adequate antimicrobial therapy. […] A laboratory diagnosis can be carried out using three different approaches and microbiological procedures: direct diagnosis by culture, indirect diagnosis by serological tests, and rapid diagnosis by molecular PCR-based methods. […] The indirect diagnosis is based on serological tests detecting antibodies in the serum of patients. […] Despite being imperfect, serological tests remain the main diagnostic methods for the diagnosis of brucellosis in endemic and low-to-middle-income countries because they are low cost and user friendly and have a high negative predictive value.

• #6 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Definite diagnosis of brucellosis requires the isolation of the organism from the blood, body fluids, or tissues, but serological methods may be the only tests available in many settings. […] Positive blood culture yield ranges between 40 and 70% and is less commonly positive for B. abortus than B. melitensis or B. suis. […] Identification of specific antibodies against bacterial lipopolysaccharide and other antigens can be detected by the standard agglutination test (SAT), rose Bengal, 2-mercaptoethanol (2-ME), antihuman globulin (Coombs’) and indirect enzyme-linked immunosorbent assay (ELISA). […] SAT is the most commonly used serology in endemic areas. […] An agglutination titre greater than 1:160 is considered significant in nonendemic areas and greater than 1:320 in endemic areas.

• #7 Clinical Overview of Brucellosis | Brucellosis | CDC

  https://www.cdc.gov/brucellosis/hcp/clinical-overview/index.html

  Brucellosis in people cannot be diagnosed by clinical symptoms alone as initial symptoms are non-specific and can vary between patients. Laboratory testing is required to confirm a diagnosis. […] If a patient has brucellosis symptoms, determining the route of exposure history can help you determine the right kind of laboratory testing (serology or culture, for instance). […] Most commercial clinical laboratories run serological tests that can detect antibodies to three Brucella species: B. abortus, B. melitensis, or B. suis. […] Some labs can also conduct culture tests on cerebrospinal fluid, purulent discharge, or joint fluid. […] Infection with B. canis and Brucella RB51 cannot be detected through serology testing, so labs will have to confirm the infection by these Brucellae with a culture.

• #8 Brucellosis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17886-brucellosis

  How is brucellosis diagnosed? A healthcare provider diagnoses brucellosis by asking about your symptoms and testing your blood, tissues or other samples for signs of the bacteria Brucella. As symptoms of brucellosis can look like other diseases, your provider may test you for other conditions to rule them out. […] The best way to confirm a Brucella infection is through growing the bacteria from body fluid or tissue. Brucella is slow-growing, so it may take a few weeks to confirm your diagnosis. You may need to do more than one blood test over a few weeks to check for signs of Brucella. […] What tests will be done to diagnose brucellosis? Your provider might get body fluid samples, and use imaging or other tests to help diagnose brucellosis, including: Blood tests. Your provider will take a sample of your blood from your arm using a needle. A lab can look for signs of Brucella (antibodies, antigens or DNA) in your blood or try to grow it over time (culture).

• #9 Brucellosis | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/brucellosis-16689930.html

  Brucellosis is a zoonosis that mainly affects livestock animals. […] Diagnosis is difficult because of the broad spectrum of fluctuating and non-specific clinical manifestations. In patients with unexplained fever, brucellosis should be considered when risk factors are present: consumption of unpasteurized milk products; exposure to livestock (e.g. livestock farmers, veterinarians, butchers, slaughterhouse workers). […] Blood culture is the gold standard for diagnosis. It is positive only in the acute phase. The bacteria grow slowly (7 to 21 days). […] Serological tests (Rose Bengal, Wright agglutination test, indirect immunofluorescence, ELISA, etc.) provide presumptive diagnoses.

• #10 Laboratory Diagnosis of Human Brucellosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6860005/

  The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patients proper treatment. The diagnosis of brucellar infections can be made by culture, serological tests, and nucleic acid amplification assays. […] Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases. […] Serological tests, though they lack specificity and provide results that may be difficult to interpret in individuals repeatedly exposed to Brucella organisms, nevertheless remain a diagnostic cornerstone in resource-poor countries.

• #11 Laboratory Diagnosis of Human Brucellosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6860005/

  The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patients proper treatment. The diagnosis of brucellar infections can be made by culture, serological tests, and nucleic acid amplification assays. […] Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases. […] Serological tests, though they lack specificity and provide results that may be difficult to interpret in individuals repeatedly exposed to Brucella organisms, nevertheless remain a diagnostic cornerstone in resource-poor countries.

• #12 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Definite diagnosis of brucellosis requires the isolation of the organism from the blood, body fluids, or tissues, but serological methods may be the only tests available in many settings. […] Positive blood culture yield ranges between 40 and 70% and is less commonly positive for B. abortus than B. melitensis or B. suis. […] Identification of specific antibodies against bacterial lipopolysaccharide and other antigens can be detected by the standard agglutination test (SAT), rose Bengal, 2-mercaptoethanol (2-ME), antihuman globulin (Coombs’) and indirect enzyme-linked immunosorbent assay (ELISA). […] SAT is the most commonly used serology in endemic areas. […] An agglutination titre greater than 1:160 is considered significant in nonendemic areas and greater than 1:320 in endemic areas.

• #13 Brucellosis, Diagnosis of Brucella Infection – Labpedia.net

  https://labpedia.net/brucellosis-diagnosis-of-brucella-infection/

  It is done on the serum of the patient. […] Brucella can be cultured from the blood, sputum, bone marrow, CSF, tissue, lymph node, and urine. […] The patient with a fever of unknown origin. […] The patient with a suspected history of contact with cattle. […] The patient with signs and symptoms of Brucella infection. […] Diagnosis of brucella infection: Brucellosis and its association with animals. […] By serological test detecting the Brucella antibodies. […] A skin test with brucellergin is available, but a positive result only indicates exposure to the organism and does not prove active disease. […] Blood culture. This is positive in 30% to 40% of the cases. […] Bone marrow culture may be positive when blood culture and serologic tests are negative. […] Test results 1:80 are suspicious for brucellosis. The serologic tests become positive during the second to the third week of illness.

• #14 Brucellosis Workup: Approach Considerations, Laboratory Studies, Radiography

  https://emedicine.medscape.com/article/213430-workup

  Because the reticuloendothelial system holds a high concentration of brucellae, bone marrow culture is thought to be the criterion standard. […] Serologic testing is the most commonly used method of diagnosing brucellosis. […] The tube agglutination test, developed by Bruce, measures antibodies against smooth lipopolysaccharide (LPS); it remains the most popular test tool for the diagnosis of brucellosis. […] Titers higher than 1:160 in conjunction with a compatible clinical presentation are considered highly suggestive of infection. […] The shortcomings of agglutination tests test include potential cross-reactivity with IgM of other organisms such as Francisella tularensis, Salmonella urbana, Yersinia enterocolitica serotype O9, Vibrio cholerae, Afipia clevelandensis, and some other bacteria.

• #15 Brucellosis Workup: Approach Considerations, Laboratory Studies, Radiography

  https://emedicine.medscape.com/article/213430-workup

  Because the reticuloendothelial system holds a high concentration of brucellae, bone marrow culture is thought to be the criterion standard. […] Serologic testing is the most commonly used method of diagnosing brucellosis. […] The tube agglutination test, developed by Bruce, measures antibodies against smooth lipopolysaccharide (LPS); it remains the most popular test tool for the diagnosis of brucellosis. […] Titers higher than 1:160 in conjunction with a compatible clinical presentation are considered highly suggestive of infection. […] The shortcomings of agglutination tests test include potential cross-reactivity with IgM of other organisms such as Francisella tularensis, Salmonella urbana, Yersinia enterocolitica serotype O9, Vibrio cholerae, Afipia clevelandensis, and some other bacteria.

• #16 Serology for brucellosis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/tests/serology-for-brucellosis

  Serology for brucellosis is a blood test to look for the presence of antibodies against Brucella. These are the bacteria that cause the disease brucellosis. […] Your health care provider may order this test if you have signs or symptoms of brucellosis. People who often come in contact with animals or meat are most likely to get this disease. […] A normal (negative) result usually means you have not come in contact with the bacteria that causes brucellosis. However, this test may not detect the disease at an early stage. […] An abnormal (positive) result usually means you have come in contact with the bacteria that causes brucellosis or a closely related bacteria. However, this positive result does not mean that you have an active infection.

• #17 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Definite diagnosis of brucellosis requires the isolation of the organism from the blood, body fluids, or tissues, but serological methods may be the only tests available in many settings. […] Positive blood culture yield ranges between 40 and 70% and is less commonly positive for B. abortus than B. melitensis or B. suis. […] Identification of specific antibodies against bacterial lipopolysaccharide and other antigens can be detected by the standard agglutination test (SAT), rose Bengal, 2-mercaptoethanol (2-ME), antihuman globulin (Coombs’) and indirect enzyme-linked immunosorbent assay (ELISA). […] SAT is the most commonly used serology in endemic areas. […] An agglutination titre greater than 1:160 is considered significant in nonendemic areas and greater than 1:320 in endemic areas.

• #18 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Dipstick assays are new and promising, based on the binding of Brucella IgM antibodies, and are simple, accurate, and rapid. […] ELISA typically uses cytoplasmic proteins as antigens. […] It measures IgM, IgG, and IgA with better sensitivity and specificity than the SAT in most recent comparative studies. […] The commercial Brucellacapt test, a single-step immunocapture assay for the detection of total anti-Brucella antibodies, is an increasingly used adjunctive test when resources permit. […] PCR is fast and should be specific. […] Many varieties of PCR have been developed (e.g. nested PCR, realtime PCR, and PCR-ELISA) and found to have superior specificity and sensitivity in detecting both primary infection and relapse after treatment. […] Other laboratory findings include normal peripheral white cell count, and occasional leucopenia with relative lymphocytosis. The serum biochemical profiles are commonly normal.

• #19 Brucella: Properties, Pathogenesis, Lab Diagnosis • Microbe Online

  https://microbeonline.com/brucellosis-etiology-pathogenesis-laboratory-diagnosis/

  Blood cultures are positive in 53.4 to 90% of patients with brucellosis. A biphasic medium (Castenda method of blood culture) consisting of a solid and a liquid phase in the same blood culture is used for the isolation of the Brucella. […] Brucella is a very slow-growing organism so the Blood culture must be incubated for a period of 6-8 weeks before discarding as culture negative. Periodic transfer (subculture) to serum-supplemented solid media every 3-5 days is needed to isolate the organism. […] Rose Bengal Plate test is the most widely used screening test for brucellosis. It can be used as spot agglutination test using stained antigen. In the absence of an acute phase specimen, a titer of at least 1: 160 in the convalescent-phase serum sample is diagnostic. Serological methods include agglutination, complement fixation and ELISA.

• #20 Brucella: Properties, Pathogenesis, Lab Diagnosis • Microbe Online

  https://microbeonline.com/brucellosis-etiology-pathogenesis-laboratory-diagnosis/

  Blood cultures are positive in 53.4 to 90% of patients with brucellosis. A biphasic medium (Castenda method of blood culture) consisting of a solid and a liquid phase in the same blood culture is used for the isolation of the Brucella. […] Brucella is a very slow-growing organism so the Blood culture must be incubated for a period of 6-8 weeks before discarding as culture negative. Periodic transfer (subculture) to serum-supplemented solid media every 3-5 days is needed to isolate the organism. […] Rose Bengal Plate test is the most widely used screening test for brucellosis. It can be used as spot agglutination test using stained antigen. In the absence of an acute phase specimen, a titer of at least 1: 160 in the convalescent-phase serum sample is diagnostic. Serological methods include agglutination, complement fixation and ELISA.

• #21 Brucellosis Workup: Approach Considerations, Laboratory Studies, Radiography

  https://emedicine.medscape.com/article/213430-workup

  Because the reticuloendothelial system holds a high concentration of brucellae, bone marrow culture is thought to be the criterion standard. […] Serologic testing is the most commonly used method of diagnosing brucellosis. […] The tube agglutination test, developed by Bruce, measures antibodies against smooth lipopolysaccharide (LPS); it remains the most popular test tool for the diagnosis of brucellosis. […] Titers higher than 1:160 in conjunction with a compatible clinical presentation are considered highly suggestive of infection. […] The shortcomings of agglutination tests test include potential cross-reactivity with IgM of other organisms such as Francisella tularensis, Salmonella urbana, Yersinia enterocolitica serotype O9, Vibrio cholerae, Afipia clevelandensis, and some other bacteria.

• #22 Brucellosis Workup: Approach Considerations, Laboratory Studies, Radiography

  https://emedicine.medscape.com/article/213430-workup

  Enzyme-linked immunosorbent assay (ELISA) typically uses the cytoplasmic proteins as antigens and measures IgM, IgG, and IgA, allowing better interpretation, especially in cases of brucellosis relapse. […] Polymerase chain reaction (PCR) tests have been developed for the detection and rapid diagnosis of Brucella species in human blood specimens. […] Other promising tests include nested PCR, real-time PCR, and PCR-ELISA, but the clinical roles for all of these tests remain to be defined.

• #23 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Dipstick assays are new and promising, based on the binding of Brucella IgM antibodies, and are simple, accurate, and rapid. […] ELISA typically uses cytoplasmic proteins as antigens. […] It measures IgM, IgG, and IgA with better sensitivity and specificity than the SAT in most recent comparative studies. […] The commercial Brucellacapt test, a single-step immunocapture assay for the detection of total anti-Brucella antibodies, is an increasingly used adjunctive test when resources permit. […] PCR is fast and should be specific. […] Many varieties of PCR have been developed (e.g. nested PCR, realtime PCR, and PCR-ELISA) and found to have superior specificity and sensitivity in detecting both primary infection and relapse after treatment. […] Other laboratory findings include normal peripheral white cell count, and occasional leucopenia with relative lymphocytosis. The serum biochemical profiles are commonly normal.

• #24 Brucellosis: Review on the Recent Trends in Pathogenicity and Laboratory Diagnosis – Journal of Laboratory Physicians

  https://jlabphy.org/brucellosis-review-on-the-recent-trends-in-pathogenicity-and-laboratory-diagnosis/

  The Rose Bengal test is used as a screening test and positive results are confirmed by the serum agglutination tests. […] The Standard Tube Agglutination Test (SAT) developed by Wright and colleagues remains the most popular and easy test to perform. […] Enzyme linked immunosorbant assay (ELISA) has become increasingly popular, as well as a standardized assay for brucellosis. […] The Fluorescence polarization assay (FPA) offers a valuable alternative to conventional serological tests. […] Over the past decade there has been a major advancement in all aspects of molecular diagnostics with regard to human brucellosis. […] Several genus-specific PCR systems using primer pairs that target 16SRNA sequences and genes of different outer membrane proteins have been developed. […] PCR is also useful in species differentiation and biotyping of isolates. […] The sensitivity and specificity of PCR for Brucella varies between laboratories, and hence standardization is required.

• #25 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Definite diagnosis of brucellosis requires the isolation of the organism from the blood, body fluids, or tissues, but serological methods may be the only tests available in many settings. […] Positive blood culture yield ranges between 40 and 70% and is less commonly positive for B. abortus than B. melitensis or B. suis. […] Identification of specific antibodies against bacterial lipopolysaccharide and other antigens can be detected by the standard agglutination test (SAT), rose Bengal, 2-mercaptoethanol (2-ME), antihuman globulin (Coombs’) and indirect enzyme-linked immunosorbent assay (ELISA). […] SAT is the most commonly used serology in endemic areas. […] An agglutination titre greater than 1:160 is considered significant in nonendemic areas and greater than 1:320 in endemic areas.

• #26 Brucellosis Workup: Approach Considerations, Laboratory Studies, Radiography

  https://emedicine.medscape.com/article/213430-workup

  Because the reticuloendothelial system holds a high concentration of brucellae, bone marrow culture is thought to be the criterion standard. […] Serologic testing is the most commonly used method of diagnosing brucellosis. […] The tube agglutination test, developed by Bruce, measures antibodies against smooth lipopolysaccharide (LPS); it remains the most popular test tool for the diagnosis of brucellosis. […] Titers higher than 1:160 in conjunction with a compatible clinical presentation are considered highly suggestive of infection. […] The shortcomings of agglutination tests test include potential cross-reactivity with IgM of other organisms such as Francisella tularensis, Salmonella urbana, Yersinia enterocolitica serotype O9, Vibrio cholerae, Afipia clevelandensis, and some other bacteria.

• #27 Clinical Overview of Brucellosis | Brucellosis | CDC

  https://www.cdc.gov/brucellosis/hcp/clinical-overview/index.html

  Some serology tests require two serum samples to confirm brucellosis, the first within 7 days of symptom onset, the second 2-4 weeks later to compare antibody levels. […] If having two sera samples isn’t possible, you can make a probable diagnosis from a single sample. […] Always inform the lab that you suspect brucellosis when submitting a sample. This information allows lab staff to take precautions when performing testing to prevent exposures to the bacteria. […] Once brucellosis has been confirmed by lab testing, start treatment immediately to help prevent chronic infection-associated arthritis, endocarditis, chronic fatigue, depression, and/or swelling of the liver or spleen. […] B. melitensis, B. abortus, B. suis, and B. canis infections are typically treated with a combination of doxycycline and rifampin for at least 6 weeks.

• #28 Brucella Species – Brucellosis | Choose the Right Test

  https://arupconsult.com/content/brucella-species

  For definitive diagnosis, two serum samples are required. […] A fourfold or greater increase from the first sample to the second is considered diagnostic. […] The CDC considers a positive PCR test result to be presumptively diagnostic for brucellosis rather than definitively diagnostic. […] Individuals with suspected exposure should undergo serology testing to detect a possible immune response to Brucella.

• #29 Brucellosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-negative-bacilli/brucellosis

  Brucellosis is caused by Brucella species, which are gram-negative bacteria. Diagnosis is by culture, usually from the blood. […] Blood cultures should be obtained, but sensitivity is limited; growth may take 7 days, and subcultures using special media may need to be held for up to 3 to 4 weeks, so the laboratory should be notified of the suspicion of brucellosis. […] Acute and convalescent sera should be obtained 3 weeks apart. A 4-fold increase or an acute titer of 1:160 or higher is considered diagnostic, particularly if a history of exposure and characteristic clinical findings are present. […] PCR assay can be done on blood or any body tissue and can be positive as early as 10 days after inoculation. […] Diagnose using cultures of blood, bone marrow, or cerebrospinal fluid and acute and convalescent serologic testing.

• #30 Brucellosis Workup: Approach Considerations, Laboratory Studies, Radiography

  https://emedicine.medscape.com/article/213430-workup

  Enzyme-linked immunosorbent assay (ELISA) typically uses the cytoplasmic proteins as antigens and measures IgM, IgG, and IgA, allowing better interpretation, especially in cases of brucellosis relapse. […] Polymerase chain reaction (PCR) tests have been developed for the detection and rapid diagnosis of Brucella species in human blood specimens. […] Other promising tests include nested PCR, real-time PCR, and PCR-ELISA, but the clinical roles for all of these tests remain to be defined.

• #31 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Dipstick assays are new and promising, based on the binding of Brucella IgM antibodies, and are simple, accurate, and rapid. […] ELISA typically uses cytoplasmic proteins as antigens. […] It measures IgM, IgG, and IgA with better sensitivity and specificity than the SAT in most recent comparative studies. […] The commercial Brucellacapt test, a single-step immunocapture assay for the detection of total anti-Brucella antibodies, is an increasingly used adjunctive test when resources permit. […] PCR is fast and should be specific. […] Many varieties of PCR have been developed (e.g. nested PCR, realtime PCR, and PCR-ELISA) and found to have superior specificity and sensitivity in detecting both primary infection and relapse after treatment. […] Other laboratory findings include normal peripheral white cell count, and occasional leucopenia with relative lymphocytosis. The serum biochemical profiles are commonly normal.

• #32 Microbiological Laboratory Diagnosis of Human Brucellosis: An Overview

  https://www.mdpi.com/2076-0817/10/12/1623

  Brucella spp. are Gram-negative, non-motile, non-spore-forming, slow-growing, facultative intracellular bacteria causing brucellosis. […] A microbiological analysis is crucial to identifying human cases because clinical symptoms of human brucellosis are variable and aspecific. The laboratory diagnosis is based on three different microbiological approaches: (i) direct diagnosis by culture, (ii) indirect diagnosis by serological tests, and (iii) direct rapid diagnosis by molecular PCR-based methods. […] Despite the established experience with serological tests and highly sensitive nucleic acid amplification tests (NAATs), a culture is still considered the “gold standard” in the laboratory diagnosis of brucellosis due to its clinical and epidemiological relevance. […] The main limitations of serological tests are the lack of common interpretative criteria, the suboptimal specificity due to interspecies cross-reactivity, and the low sensitivity during the early stage of disease.

• #33 Brucellosis Workup: Approach Considerations, Laboratory Studies, Radiography

  https://emedicine.medscape.com/article/213430-workup

  Because the reticuloendothelial system holds a high concentration of brucellae, bone marrow culture is thought to be the criterion standard. […] Serologic testing is the most commonly used method of diagnosing brucellosis. […] The tube agglutination test, developed by Bruce, measures antibodies against smooth lipopolysaccharide (LPS); it remains the most popular test tool for the diagnosis of brucellosis. […] Titers higher than 1:160 in conjunction with a compatible clinical presentation are considered highly suggestive of infection. […] The shortcomings of agglutination tests test include potential cross-reactivity with IgM of other organisms such as Francisella tularensis, Salmonella urbana, Yersinia enterocolitica serotype O9, Vibrio cholerae, Afipia clevelandensis, and some other bacteria.

• #34 Microbiological Laboratory Diagnosis of Human Brucellosis: An Overview

  https://www.mdpi.com/2076-0817/10/12/1623

  NAATs are rapid tests that can help diagnose brucellosis in a few hours with high sensitivity and specificity. […] The fast and precise diagnosis of human brucellosis is essential for the delivery of a prompt and adequate antimicrobial therapy. […] A laboratory diagnosis can be carried out using three different approaches and microbiological procedures: direct diagnosis by culture, indirect diagnosis by serological tests, and rapid diagnosis by molecular PCR-based methods. […] The indirect diagnosis is based on serological tests detecting antibodies in the serum of patients. […] Despite being imperfect, serological tests remain the main diagnostic methods for the diagnosis of brucellosis in endemic and low-to-middle-income countries because they are low cost and user friendly and have a high negative predictive value.

• #35 Laboratory Diagnosis of Human Brucellosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6860005/

  Nucleic acid amplification assays combine exquisite sensitivity, specificity, and safety and enable rapid diagnosis of the disease. […] Therefore, as long as there are no sufficiently validated commercial tests or studies that demonstrate an adequate interlaboratory reproducibility of the different homemade PCR assays, cultures and serological methods will remain the primary tools for the diagnosis and posttherapeutic follow-up of human brucellosis.

• #36 Brucellosis Workup: Approach Considerations, Laboratory Studies, Radiography

  https://emedicine.medscape.com/article/213430-workup

  Enzyme-linked immunosorbent assay (ELISA) typically uses the cytoplasmic proteins as antigens and measures IgM, IgG, and IgA, allowing better interpretation, especially in cases of brucellosis relapse. […] Polymerase chain reaction (PCR) tests have been developed for the detection and rapid diagnosis of Brucella species in human blood specimens. […] Other promising tests include nested PCR, real-time PCR, and PCR-ELISA, but the clinical roles for all of these tests remain to be defined.

• #37 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Dipstick assays are new and promising, based on the binding of Brucella IgM antibodies, and are simple, accurate, and rapid. […] ELISA typically uses cytoplasmic proteins as antigens. […] It measures IgM, IgG, and IgA with better sensitivity and specificity than the SAT in most recent comparative studies. […] The commercial Brucellacapt test, a single-step immunocapture assay for the detection of total anti-Brucella antibodies, is an increasingly used adjunctive test when resources permit. […] PCR is fast and should be specific. […] Many varieties of PCR have been developed (e.g. nested PCR, realtime PCR, and PCR-ELISA) and found to have superior specificity and sensitivity in detecting both primary infection and relapse after treatment. […] Other laboratory findings include normal peripheral white cell count, and occasional leucopenia with relative lymphocytosis. The serum biochemical profiles are commonly normal.

• #38 Polymerase chain reaction–based assays for the diagnosis of human brucellosis | Annals of Clinical Microbiology and Antimicrobials | Full Text

  https://ann-clinmicrob.biomedcentral.com/articles/10.1186/s12941-014-0031-7

  Polymerase chain reaction (PCR) technique offers a sensitive and specific way of detecting Brucella spp. from peripheral blood and other tissues. […] Several studies have reported that PCR is a very useful tool for the rapid diagnosis of acute brucellosis and a good marker for the posttreatment follow-up and the early detection of relapses. […] The standard PCR is simple and efficient. However, efficiency of this method is dependent on the specificity of the primers. […] Studies showed that standard PCR appeared to be a more sensitive technique than microbiological methods, not only for the diagnosis of a first episode of infection, but also for the early detection of relapses. […] Real-time PCR seems to be highly reproducible, rapid, sensitive and specific. […] This assay was found to be 91.9% sensitive and 95.4% specific when tested with 65 negative control samples and 62 serum samples from patients with active brucellosis.

• #39 Polymerase chain reaction–based assays for the diagnosis of human brucellosis | Annals of Clinical Microbiology and Antimicrobials | Full Text

  https://ann-clinmicrob.biomedcentral.com/articles/10.1186/s12941-014-0031-7

  The results showed that the IS711-based real-time PCR was the most sensitive, specific and efficient to detect Brucella spp. […] The nested PCR and semi-nested PCR amplify only the specific sequences sought and are more specific than the standard PCR. […] Recently, nested PCR and semi-nested PCR assays were developed for identifying Brucella in samples of human blood and then to explore their clinical practice for the diagnosis of human brucellosis. […] PCR-based assays were shown to be valuable tools for detecting Brucella strains. […] This technique might be considered complementary to the traditional methods and followed up by serology and/or culture. […] However, its disadvantages such as the higher cost, issues of quality control and quality assurance must be further evaluated on clinical samples before PCR can be used in routine laboratory testing for human brucellosis. […] Several previous studies reported the applications of PCR for the diagnosis of post treatment follow-up and relapses. […] The implementation of PCR-based assays into the clinical setting will likely improve therapeutic outcomes.

• #40 Microbiological Laboratory Diagnosis of Human Brucellosis: An Overview

  https://www.mdpi.com/2076-0817/10/12/1623

  Molecular methods used to identify brucellae to species level and genotyping include fluorescence in situ hybridization (FISH) test, targeting a partial region of the 16S rRNA gene with rapid and precise detection of all human pathogenic species. […] Rapid, reliable, and affordable detection of Brucella spp. via molecular methods remains a challenge.

• #41 Polymerase chain reaction–based assays for the diagnosis of human brucellosis | Annals of Clinical Microbiology and Antimicrobials | Full Text

  https://ann-clinmicrob.biomedcentral.com/articles/10.1186/s12941-014-0031-7

  Polymerase chain reaction (PCR) technique offers a sensitive and specific way of detecting Brucella spp. from peripheral blood and other tissues. […] Several studies have reported that PCR is a very useful tool for the rapid diagnosis of acute brucellosis and a good marker for the posttreatment follow-up and the early detection of relapses. […] The standard PCR is simple and efficient. However, efficiency of this method is dependent on the specificity of the primers. […] Studies showed that standard PCR appeared to be a more sensitive technique than microbiological methods, not only for the diagnosis of a first episode of infection, but also for the early detection of relapses. […] Real-time PCR seems to be highly reproducible, rapid, sensitive and specific. […] This assay was found to be 91.9% sensitive and 95.4% specific when tested with 65 negative control samples and 62 serum samples from patients with active brucellosis.

• #42 Polymerase chain reaction–based assays for the diagnosis of human brucellosis | Annals of Clinical Microbiology and Antimicrobials | Full Text

  https://ann-clinmicrob.biomedcentral.com/articles/10.1186/s12941-014-0031-7

  The results showed that the IS711-based real-time PCR was the most sensitive, specific and efficient to detect Brucella spp. […] The nested PCR and semi-nested PCR amplify only the specific sequences sought and are more specific than the standard PCR. […] Recently, nested PCR and semi-nested PCR assays were developed for identifying Brucella in samples of human blood and then to explore their clinical practice for the diagnosis of human brucellosis. […] PCR-based assays were shown to be valuable tools for detecting Brucella strains. […] This technique might be considered complementary to the traditional methods and followed up by serology and/or culture. […] However, its disadvantages such as the higher cost, issues of quality control and quality assurance must be further evaluated on clinical samples before PCR can be used in routine laboratory testing for human brucellosis. […] Several previous studies reported the applications of PCR for the diagnosis of post treatment follow-up and relapses. […] The implementation of PCR-based assays into the clinical setting will likely improve therapeutic outcomes.

• #43 Brucella Species – Brucellosis | Choose the Right Test

  https://arupconsult.com/content/brucella-species

  For definitive diagnosis, two serum samples are required. […] A fourfold or greater increase from the first sample to the second is considered diagnostic. […] The CDC considers a positive PCR test result to be presumptively diagnostic for brucellosis rather than definitively diagnostic. […] Individuals with suspected exposure should undergo serology testing to detect a possible immune response to Brucella.

• #44 Laboratory Diagnosis of Human Brucellosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6860005/

  Nucleic acid amplification assays combine exquisite sensitivity, specificity, and safety and enable rapid diagnosis of the disease. […] Therefore, as long as there are no sufficiently validated commercial tests or studies that demonstrate an adequate interlaboratory reproducibility of the different homemade PCR assays, cultures and serological methods will remain the primary tools for the diagnosis and posttherapeutic follow-up of human brucellosis.

• #45 Brucellosis differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Brucellosis_differential_diagnosis

  Brucellosis must be differentiated from typhoid fever, malaria, tuberculosis, lymphoma, dengue, leptospirosis, rheumatic disease, epstein-barr virus, toxoplasmosis, cytomegalovirus, and HIV. […] A detailed clinical history which includes recent travel history, recent camping or hunting, consumption of unpasteurized milk or raw meat products, and occupational history should be obtained, in order to differentiate brucellosis from other diseases. […] Brucellosis must be differentiated from other diseases that cause atypical pneumonia such as Q fever and legionaellosis. […] Antibody detection using indirect immunofluorescence (IIF) is the preferred method for diagnosis. […] PCR can be used if IIF is negative, or very early once disease is suspected.

• #46 Brucellosis differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Brucellosis_differential_diagnosis

  Brucellosis must be differentiated from typhoid fever, malaria, tuberculosis, lymphoma, dengue, leptospirosis, rheumatic disease, epstein-barr virus, toxoplasmosis, cytomegalovirus, and HIV. […] A detailed clinical history which includes recent travel history, recent camping or hunting, consumption of unpasteurized milk or raw meat products, and occupational history should be obtained, in order to differentiate brucellosis from other diseases. […] Brucellosis must be differentiated from other diseases that cause atypical pneumonia such as Q fever and legionaellosis. […] Antibody detection using indirect immunofluorescence (IIF) is the preferred method for diagnosis. […] PCR can be used if IIF is negative, or very early once disease is suspected.

• #47 Clinical Overview of Brucellosis | Brucellosis | CDC

  https://www.cdc.gov/brucellosis/hcp/clinical-overview/index.html

  Brucellosis in people cannot be diagnosed by clinical symptoms alone as initial symptoms are non-specific and can vary between patients. Laboratory testing is required to confirm a diagnosis. […] If a patient has brucellosis symptoms, determining the route of exposure history can help you determine the right kind of laboratory testing (serology or culture, for instance). […] Most commercial clinical laboratories run serological tests that can detect antibodies to three Brucella species: B. abortus, B. melitensis, or B. suis. […] Some labs can also conduct culture tests on cerebrospinal fluid, purulent discharge, or joint fluid. […] Infection with B. canis and Brucella RB51 cannot be detected through serology testing, so labs will have to confirm the infection by these Brucellae with a culture.

• #48 Brucellosis diagnosis difficult; key questions can save lives | Food Safety NewsLexBlog Logo

  https://www.foodsafetynews.com/2017/12/brucellosis-diagnosis-difficult-key-questions-can-save-lives/

  It’s not every day that doctors see a Brucella infection among their patients. But when brucellosis is suspected, it’s vitally important to order the right tests to diagnose and treat the disease promptly with appropriate antibiotics. […] Although brucellosis is mainly a bacterial disease of animals, several species of Brucella bacteria are known to cause disease in humans. Because the diagnostic test and treatment vary, it is important to identify not only whether a patient is infected with Brucella, but also what kind of Brucella is causing disease. […] Diagnosing brucellosis cannot be done by symptom presentation alone because initial symptoms are nonspecific and resemble those of other febrile illnesses. […] Most clinical diagnostic laboratories are able to run serologic tests, which detect an antibody response to most of the Brucella species. However, Brucella canis and Brucella RB51 won’t show up on serology, so cultures are needed to confirm the infection.

• #49

  https://www.gov.uk/guidance/bru-reference-services

  The BRU does not provide a culture confirmation service, but collaborates closely with the OIE/FAO Reference Laboratory for Brucellosis at the Animal and Plant Health Agency (APHA) in Surrey, to whom all suspect culture isolates should be sent. […] Brucella PCR is available at BRU and is routinely tested on samples that show serology compatible with possible active infection. […] Serological testing is not useful for this as Brucella antibody titres fall slowly after treatment. Follow-up serology therefore requires careful interpretation. […] Negative serology should exclude the diagnosis so always send a serum sample in the first instance. […] This species of Brucella lacks surface lipopolysaccharide (LPS) and therefore will elicit a minimal anti-LPS immunological response, hence suspected B. canis infection will not be identified by standard Brucella antibody screening tests.

• #50

  https://www.gov.uk/guidance/bru-reference-services

  Patients with brucellar epididymo-orchitis are typically diagnosed on the basis of positive blood cultures or serology, or both. It is uncommon for urine analysis to show abnormalities. […] Patients who have previously had a clinical diagnosis of brucellosis should not donate blood. […] Patients who have had a high risk exposure to brucellosis (usually in the context of a laboratory exposure) should have serology testing before donating blood.

• #51 Brucellosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/brucellosis/diagnosis-treatment/drc-20351744

  Diagnosis of brucellosis is made by testing blood or the spongy matter inside the bones, called bone marrow. Other tests can help find complications of brucellosis. They include: […] X-rays can show changes in the bones and joints. […] CT scan or MRI scan. These imaging tests can show areas of the brain or other tissues that might be affected by brucellosis. […] Cerebrospinal fluid culture. This checks a small sample of the fluid that surrounds your brain and spinal cord for infections such as meningitis and encephalitis. […] Echocardiography. This test uses sound waves to make pictures of the heart to check for signs of infection or damage to the heart. […] A diagnosis of brucellosis depends on your coming into contact with the bacteria that cause the disease.

• #52 Brucellosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/brucellosis/diagnosis-treatment/drc-20351744

  Diagnosis of brucellosis is made by testing blood or the spongy matter inside the bones, called bone marrow. Other tests can help find complications of brucellosis. They include: […] X-rays can show changes in the bones and joints. […] CT scan or MRI scan. These imaging tests can show areas of the brain or other tissues that might be affected by brucellosis. […] Cerebrospinal fluid culture. This checks a small sample of the fluid that surrounds your brain and spinal cord for infections such as meningitis and encephalitis. […] Echocardiography. This test uses sound waves to make pictures of the heart to check for signs of infection or damage to the heart. […] A diagnosis of brucellosis depends on your coming into contact with the bacteria that cause the disease.

• #53 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  The diagnosis of brucellosis relies on: […] Demonstration of the agent: blood cultures in tryptose broth, bone marrow cultures: The growth of brucellae is extremely slow (they can take up to two months to grow) and the culture poses a risk to laboratory personnel due to high infectivity of brucellae. […] Demonstration of antibodies against the agent either with the classic Huddleson, Wright, and/or Bengal Rose reactions, either with ELISA or the 2-mercaptoethanol assay for IgM antibodies associated with chronic disease. […] Histologic evidence of granulomatous hepatitis on hepatic biopsy. […] Radiologic alterations in infected vertebrae: the Pedro Pons sign (preferential erosion of the anterosuperior corner of lumbar vertebrae) and marked osteophytosis are suspicious of brucellic spondylitis.

• #54 Brucellosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/brucellosis/diagnosis-treatment/drc-20351744

  Diagnosis of brucellosis is made by testing blood or the spongy matter inside the bones, called bone marrow. Other tests can help find complications of brucellosis. They include: […] X-rays can show changes in the bones and joints. […] CT scan or MRI scan. These imaging tests can show areas of the brain or other tissues that might be affected by brucellosis. […] Cerebrospinal fluid culture. This checks a small sample of the fluid that surrounds your brain and spinal cord for infections such as meningitis and encephalitis. […] Echocardiography. This test uses sound waves to make pictures of the heart to check for signs of infection or damage to the heart. […] A diagnosis of brucellosis depends on your coming into contact with the bacteria that cause the disease.

• #55 Brucellosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/brucellosis/diagnosis-treatment/drc-20351744

  Diagnosis of brucellosis is made by testing blood or the spongy matter inside the bones, called bone marrow. Other tests can help find complications of brucellosis. They include: […] X-rays can show changes in the bones and joints. […] CT scan or MRI scan. These imaging tests can show areas of the brain or other tissues that might be affected by brucellosis. […] Cerebrospinal fluid culture. This checks a small sample of the fluid that surrounds your brain and spinal cord for infections such as meningitis and encephalitis. […] Echocardiography. This test uses sound waves to make pictures of the heart to check for signs of infection or damage to the heart. […] A diagnosis of brucellosis depends on your coming into contact with the bacteria that cause the disease.

• #56 Brucellosis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/911

  Brucellosis is one of the world’s most common zoonoses, particularly in poor rural settings. […] Combination antibiotic therapy is the mainstay of treatment and should be used for prolonged periods to prevent relapse of symptoms. There is disagreement about the optimum treatment regimen. […] Key diagnostic factors include history of contact with infected person, fever or chills, constitutional symptoms, arthralgia, joint swelling and tenderness, hepatomegaly and/or splenomegaly. […] 1st tests to order include blood culture, serologic tests, cerebrospinal fluid (CSF) analysis, cerebrospinal fluid (CSF) culture, synovial fluid analysis, synovial fluid culture, CBC, liver function tests, serum electrolytes. […] Emerging tests include polymerase chain reaction for detection and diagnosis of Brucella species, matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry.

• #57 Brucellosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/brucellosis/diagnosis-treatment/drc-20351744

  Diagnosis of brucellosis is made by testing blood or the spongy matter inside the bones, called bone marrow. Other tests can help find complications of brucellosis. They include: […] X-rays can show changes in the bones and joints. […] CT scan or MRI scan. These imaging tests can show areas of the brain or other tissues that might be affected by brucellosis. […] Cerebrospinal fluid culture. This checks a small sample of the fluid that surrounds your brain and spinal cord for infections such as meningitis and encephalitis. […] Echocardiography. This test uses sound waves to make pictures of the heart to check for signs of infection or damage to the heart. […] A diagnosis of brucellosis depends on your coming into contact with the bacteria that cause the disease.

• #58 Brucellosis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/911

  Brucellosis is one of the world’s most common zoonoses, particularly in poor rural settings. […] Combination antibiotic therapy is the mainstay of treatment and should be used for prolonged periods to prevent relapse of symptoms. There is disagreement about the optimum treatment regimen. […] Key diagnostic factors include history of contact with infected person, fever or chills, constitutional symptoms, arthralgia, joint swelling and tenderness, hepatomegaly and/or splenomegaly. […] 1st tests to order include blood culture, serologic tests, cerebrospinal fluid (CSF) analysis, cerebrospinal fluid (CSF) culture, synovial fluid analysis, synovial fluid culture, CBC, liver function tests, serum electrolytes. […] Emerging tests include polymerase chain reaction for detection and diagnosis of Brucella species, matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry.

• #59 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  The diagnosis of brucellosis relies on: […] Demonstration of the agent: blood cultures in tryptose broth, bone marrow cultures: The growth of brucellae is extremely slow (they can take up to two months to grow) and the culture poses a risk to laboratory personnel due to high infectivity of brucellae. […] Demonstration of antibodies against the agent either with the classic Huddleson, Wright, and/or Bengal Rose reactions, either with ELISA or the 2-mercaptoethanol assay for IgM antibodies associated with chronic disease. […] Histologic evidence of granulomatous hepatitis on hepatic biopsy. […] Radiologic alterations in infected vertebrae: the Pedro Pons sign (preferential erosion of the anterosuperior corner of lumbar vertebrae) and marked osteophytosis are suspicious of brucellic spondylitis.

• #60 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Dipstick assays are new and promising, based on the binding of Brucella IgM antibodies, and are simple, accurate, and rapid. […] ELISA typically uses cytoplasmic proteins as antigens. […] It measures IgM, IgG, and IgA with better sensitivity and specificity than the SAT in most recent comparative studies. […] The commercial Brucellacapt test, a single-step immunocapture assay for the detection of total anti-Brucella antibodies, is an increasingly used adjunctive test when resources permit. […] PCR is fast and should be specific. […] Many varieties of PCR have been developed (e.g. nested PCR, realtime PCR, and PCR-ELISA) and found to have superior specificity and sensitivity in detecting both primary infection and relapse after treatment. […] Other laboratory findings include normal peripheral white cell count, and occasional leucopenia with relative lymphocytosis. The serum biochemical profiles are commonly normal.

• #61 Brucellosis – Wikipedia

  https://en.wikipedia.org/wiki/Brucellosis

  Dipstick assays are new and promising, based on the binding of Brucella IgM antibodies, and are simple, accurate, and rapid. […] ELISA typically uses cytoplasmic proteins as antigens. […] It measures IgM, IgG, and IgA with better sensitivity and specificity than the SAT in most recent comparative studies. […] The commercial Brucellacapt test, a single-step immunocapture assay for the detection of total anti-Brucella antibodies, is an increasingly used adjunctive test when resources permit. […] PCR is fast and should be specific. […] Many varieties of PCR have been developed (e.g. nested PCR, realtime PCR, and PCR-ELISA) and found to have superior specificity and sensitivity in detecting both primary infection and relapse after treatment. […] Other laboratory findings include normal peripheral white cell count, and occasional leucopenia with relative lymphocytosis. The serum biochemical profiles are commonly normal.

• #62 Diagnosis of brucellosis: Combining tests to improve performance | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012442

  Serological tests remain crucial for brucellosis diagnosis, but their limitations necessitate innovative diagnostic approaches. Combining multiple serological tests in diagnostic algorithms shows promise in improving diagnostic accuracy. […] Traditional diagnostic methods for brucellosis include culture, serology, and molecular techniques. The identification of human cases of brucellosis heavily depends on microbiological analysis, given the variability and lack of specificity of the associated symptoms of this disease. […] While these approaches have been instrumental in identifying Brucella species and confirming infection, they often suffer from limitations such as low sensitivity, cross-reactivity with other pathogens, and the need for specialized laboratory facilities. […] Strategies to reduce false positives include using dilution-based cut-offs for positivity, combining multiple tests to improve diagnostic accuracy, and incorporating clinical algorithms that integrate serological modalities.

• #63 Diagnosis of brucellosis: Combining tests to improve performance | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012442

  Brucellosis, a zoonotic infectious disease caused by bacteria of the genus Brucella, remains a significant global health concern in many parts of the world. Traditional diagnostic methods, including serological tests, suffer from limitations, including low sensibility and high false-positive rates, emphasizing the need for improved diagnostic strategies. […] In this study, we aimed to optimize diagnostic accuracy by reevaluating serological tests and exploring novel diagnostic algorithms. […] Among 3587 sera analyzed, 148 were confirmed cases of human brucellosis. Individual serological tests exhibited good sensitivity and specificity but lacked diagnostic accuracy. However, combining RBT with SAT or Brucellacapt significantly improved diagnostic performance, with reduced false positives. The most promising results were observed when an algorithm was built combining RBT, Brucellacapt, and ELISA for IgM and IgG (a score value of 0.5 with 90.5% for sensitivity, 99.7% for specificity, 92.4% for PPV, and 99.6% for NPV).

• #64 Diagnosis of brucellosis: Combining tests to improve performance | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012442

  Brucellosis, a zoonotic infectious disease caused by bacteria of the genus Brucella, remains a significant global health concern in many parts of the world. Traditional diagnostic methods, including serological tests, suffer from limitations, including low sensibility and high false-positive rates, emphasizing the need for improved diagnostic strategies. […] In this study, we aimed to optimize diagnostic accuracy by reevaluating serological tests and exploring novel diagnostic algorithms. […] Among 3587 sera analyzed, 148 were confirmed cases of human brucellosis. Individual serological tests exhibited good sensitivity and specificity but lacked diagnostic accuracy. However, combining RBT with SAT or Brucellacapt significantly improved diagnostic performance, with reduced false positives. The most promising results were observed when an algorithm was built combining RBT, Brucellacapt, and ELISA for IgM and IgG (a score value of 0.5 with 90.5% for sensitivity, 99.7% for specificity, 92.4% for PPV, and 99.6% for NPV).

• #65 Diagnosis of brucellosis: Combining tests to improve performance | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012442

  By integrating multiple testing methods and combining the strengths of each, such as the sensitivity of one test and the specificity of another, we can achieve greater overall accuracy in diagnosis. This approach demonstrates the potential benefits of a comprehensive and integrated testing approach in managing brucellosis.

• #66 Pigs, pooches and pasteurisation: The changing face of brucellosis in Australia

  https://www1.racgp.org.au/ajgp/2018/march/brucellosis

  Brucellosis should be suspected in all patients with non-specific, flu-like illness who fall into one of the major risk groups (feral pig hunters, overseas travellers and migrants). […] Early diagnosis and treatment are important for preventing complications, which include osteoarticular, genitourinary or, more rarely, neurological or cardiovascular diseases. Diagnosing acute infections is based on serology and blood cultures; imaging and biopsy may be required for diagnosis of focal infections. […] If acute brucellosis is suspected, serology and blood cultures are recommended. Serum IgM is often detectable at presentation because of the insidious nature of the infection, and cannot be relied on for diagnosis as cross-reactions may occur with other infectious agents. Diagnosis of acute brucellosis is confirmed when seroconversion for Brucella IgG (enzyme-linked immunoassay) or a fourfold increase in agglutinating titres and complement fixation test (CFT) on convalescent testing are demonstrated.

• #67 Brucellosis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/brucellosis/symptoms-causes/syc-20351738

  Brucellosis can be hard to diagnose, especially in the early stages. […] Make a medical appointment if you are at risk for brucellosis and you have a fever that goes up fast or lasts, or muscle aches or unusual weakness. […] Brucellosis is rare in the United States. But it’s more common in other parts of the world, especially: […] People who work with animals or who come into contact with infected blood are at higher risk of brucellosis. […] Brucellosis can affect almost any part of the body, including the reproductive system, liver, heart and central nervous system. […] Long-term, called chronic, brucellosis may cause complications in just one organ or through the body. […] Brucellosis isn’t likely to spread from person to person. But rarely, the disease can be passed during birth or through breast milk.

• #68 Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-024-01186-4

  Understanding the true clinical spectrum of brucellosis and its complications is crucial for medical practitioners to make early decisions. […] This study identified CRP and ESR as indicators of focal involvement in brucellosis, with a cutoff value of 5.4 mg/L for CRP and 25 mm/h for ESR. […] Our study aimed to compare the demographic, clinical, and laboratory characteristics of brucellosis patients with or without complications to provide practical reference indices for clinicians in early diagnosis and patient management. More than half of the brucellosis patients experienced complications. Several factors were identified as warning signs for complications, including delayed diagnosis, underlying diseases, arthralgia, myalgia, eye bulging pain, CRP levels greater than 10 mg/L, and elevated ESR levels.

• #69 Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-024-01186-4

  Understanding the true clinical spectrum of brucellosis and its complications is crucial for medical practitioners to make early decisions. […] This study identified CRP and ESR as indicators of focal involvement in brucellosis, with a cutoff value of 5.4 mg/L for CRP and 25 mm/h for ESR. […] Our study aimed to compare the demographic, clinical, and laboratory characteristics of brucellosis patients with or without complications to provide practical reference indices for clinicians in early diagnosis and patient management. More than half of the brucellosis patients experienced complications. Several factors were identified as warning signs for complications, including delayed diagnosis, underlying diseases, arthralgia, myalgia, eye bulging pain, CRP levels greater than 10 mg/L, and elevated ESR levels.

• #70 Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-024-01186-4

  Complications are a frequent occurrence in patients with brucellosis. It is important to closely monitor patients with delayed diagnosis, underlying diseases, significant joint pain, eye bulging pain, and elevated levels of CRP or ESR during their initial visit. Additionally, early treatment should be administered with vigilance to prevent the onset of complications.

• #71 Pigs, pooches and pasteurisation: The changing face of brucellosis in Australia

  https://www1.racgp.org.au/ajgp/2018/march/brucellosis

  Blood cultures are important in the workup of suspected Brucella infection. Growth of the bacteria from blood cultures not only confirms the diagnosis, but allows speciation of Brucella which, if acquired in Australia, is invariably B. suis. […] Dual therapy with doxycycline and gentamicin is the recommended treatment for brucellosis. […] Early diagnosis and treatment is important for limiting duration and preventing complications. Dual therapy with doxycycline and gentamicin is the recommended treatment for brucellosis. Relapse can occur despite appropriate treatment.

• #72 Clinical Overview of Brucellosis | Brucellosis | CDC

  https://www.cdc.gov/brucellosis/hcp/clinical-overview/index.html

  Some serology tests require two serum samples to confirm brucellosis, the first within 7 days of symptom onset, the second 2-4 weeks later to compare antibody levels. […] If having two sera samples isn’t possible, you can make a probable diagnosis from a single sample. […] Always inform the lab that you suspect brucellosis when submitting a sample. This information allows lab staff to take precautions when performing testing to prevent exposures to the bacteria. […] Once brucellosis has been confirmed by lab testing, start treatment immediately to help prevent chronic infection-associated arthritis, endocarditis, chronic fatigue, depression, and/or swelling of the liver or spleen. […] B. melitensis, B. abortus, B. suis, and B. canis infections are typically treated with a combination of doxycycline and rifampin for at least 6 weeks.

• #73 Diagnosis of human brucellosis: Systematic review and meta-analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10950246/

  Brucellosis, a widely spread zoonotic disease, poses significant diagnostic challenges due to its non-specific symptoms and underreporting. Timely and accurate diagnosis is crucial for effective patient management and public health control. However, a comprehensive comparative review of available diagnostic tests is lacking. […] This systematic review addressed the following question: What is the accuracy of the available tests to confirm human brucellosis? […] A total of 38 studies reporting diagnostic test performance for human brucellosis were included. However, the evidence available is limited, and significant variability was observed among studies. […] Regarding the reference test, culture and/or SAT are deemed more appropriate than culture alone. Rose Bengal, IgG/IgM ELISA, and PCR exhibited equally high performances, indicating superior overall diagnostic accuracy, with very low certainty of the evidence.

• #74 Laboratory Diagnostic Procedures for Human Brucellosis: An Overview of Existing Approaches

  https://brieflands.com/articles/jjm-91200

  Diagnosis of human brucellosis still challenges clinicians and scientists with several considerable aspects, particularly in endemic countries. […] The current study aimed at reviewing laboratory tests in the diagnosis of human brucellosis. […] The article reviewed the methods for the diagnosis of human brucellosis and summarized developments for the future. […] Definitive diagnosis of brucellosis needs comprehensive evaluation of the living conditions of the patient, medical history, clinical examinations, and careful interpretation of laboratory test results and radiologic findings. […] Indeed, diagnosis of brucellosis is frequently delayed and often missed especially in the developing countries. […] The gold standard for diagnosis still is bacterial culture, which often fails. Thus, diagnosis relies on the combination of several methods.

• #75 Laboratory Diagnostic Procedures for Human Brucellosis: An Overview of Existing Approaches

  https://brieflands.com/articles/jjm-91200

  Diagnosis of human brucellosis still challenges clinicians and scientists with several considerable aspects, particularly in endemic countries. […] The current study aimed at reviewing laboratory tests in the diagnosis of human brucellosis. […] The article reviewed the methods for the diagnosis of human brucellosis and summarized developments for the future. […] Definitive diagnosis of brucellosis needs comprehensive evaluation of the living conditions of the patient, medical history, clinical examinations, and careful interpretation of laboratory test results and radiologic findings. […] Indeed, diagnosis of brucellosis is frequently delayed and often missed especially in the developing countries. […] The gold standard for diagnosis still is bacterial culture, which often fails. Thus, diagnosis relies on the combination of several methods.

• #76 Laboratory Diagnostic Procedures for Human Brucellosis: An Overview of Existing Approaches

  https://brieflands.com/articles/jjm-91200

  Diagnosis of human brucellosis still challenges clinicians and scientists with several considerable aspects, particularly in endemic countries. […] The current study aimed at reviewing laboratory tests in the diagnosis of human brucellosis. […] The article reviewed the methods for the diagnosis of human brucellosis and summarized developments for the future. […] Definitive diagnosis of brucellosis needs comprehensive evaluation of the living conditions of the patient, medical history, clinical examinations, and careful interpretation of laboratory test results and radiologic findings. […] Indeed, diagnosis of brucellosis is frequently delayed and often missed especially in the developing countries. […] The gold standard for diagnosis still is bacterial culture, which often fails. Thus, diagnosis relies on the combination of several methods.

• #77 Diagnosis of human brucellosis: Systematic review and meta-analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10950246/

  Recently, molecular methods, such as qualitative and quantitative polymerase chain reaction (PCR) targeting various genes, have also been utilized for diagnosing this disease. […] The present study aimed to systematically review the literature to summarize the evidence on the diagnostic accuracy (sensitivity and specificity) of the diagnostic tests available for diagnosing human brucellosis. […] The main study characteristics, information related to the population, intervention, comparator, and outcome were extracted from all articles by two reviewers. […] For each diagnostic test identified, the pooled sensitivity and specificity were estimated considering both Culture and Culture and/or SAT as the reference standard. […] The accuracy of qualitative PCR was evaluated in four studies, with a pooled sensitivity of 79.6% and specificity of 96.0%.

• #78 Diagnosis of human brucellosis: Systematic review and meta-analysis | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012030

  The high number of studies on Brucellosis in the Asian region is noteworthy, primarily attributed to the heightened prevalence of the disease in countries such as Turkey, Saudi Arabia, and Kuwait. Indeed, caution is necessary to extrapolating findings to other geographical areas. Variability in the performance of diagnostic tests for infectious diseases across regions requires careful consideration. […] The primary limitations of the systematic review stem from the scarcity and quality of the studies included. Due to a limited number of available studies and insufficient data from a real control group (individuals displaying symptoms resembling brucellosis but diagnosed with a different disease), information from all identified studies was incorporated, even if sensitivity and specificity were not jointly presented.

• #79 Diagnosis of human brucellosis: Systematic review and meta-analysis | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012030

  In conclusion, our systematic review sheds light on the current state of diagnostic methods for brucellosis. Despite the substantial efforts, several challenges and uncertainties remain in the field of brucellosis diagnosis. The limitations of available evidence, coupled with significant variability between studies, underline the need for further research and standardization of diagnostic protocols.

• #80 Brucellosis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17886-brucellosis

  How is brucellosis treated? Your healthcare provider will treat brucellosis with a combination of at least two types of antibiotics. Youll need to take them for at least six to eight weeks. Depending on your specific case, you may need other therapies (like draining infected areas or managing complications). […] What medications are used to treat brucellosis? Antibiotics healthcare providers prescribe to treat brucellosis include: Streptomycin or gentamicin. Rifampin. Doxycycline. Trimethoprim/sulfamethoxazole (TMP/SMX). Ciprofloxacin. […] How can I reduce my risk of brucellosis? You can reduce your risk of brucellosis by practicing safe food handling and wearing protective clothing while working with animals, for instance: Dont drink unpasteurized milk or eat foods made with unpasteurized milk.

• #81 Brucellosis

  https://dermnetnz.org/topics/brucellosis

  Brucellosis can be diagnosed by detecting Brucella organisms in samples of blood or bone marrow. Blood tests can also reveal antibodies against the bacteria. […] Brucellosis is treated with antibiotics. The WHO guidelines recommend the following regimens: […] Relapse of infection occurs in up to 10% of patients, even with appropriate treatment.

• #82

  https://www.who.int/news-room/fact-sheets/detail/brucellosis

  However, the disease may present in many atypical forms. […] In many patients the symptoms are mild and, therefore, the diagnosis may not be considered. […] Treatment options include doxycycline 100 mg twice a day for 45 days, plus streptomycin 1 g daily for 15 days. […] The optimal treatment for pregnant women, neonates and children under 8 is not yet determined. […] WHO provides technical advice to member states through provision of standards, information and guidance for the management of brucellosis in humans and animals.

• #83 Clinical Overview of Brucellosis | Brucellosis | CDC

  https://www.cdc.gov/brucellosis/hcp/clinical-overview/index.html

  Some serology tests require two serum samples to confirm brucellosis, the first within 7 days of symptom onset, the second 2-4 weeks later to compare antibody levels. […] If having two sera samples isn’t possible, you can make a probable diagnosis from a single sample. […] Always inform the lab that you suspect brucellosis when submitting a sample. This information allows lab staff to take precautions when performing testing to prevent exposures to the bacteria. […] Once brucellosis has been confirmed by lab testing, start treatment immediately to help prevent chronic infection-associated arthritis, endocarditis, chronic fatigue, depression, and/or swelling of the liver or spleen. […] B. melitensis, B. abortus, B. suis, and B. canis infections are typically treated with a combination of doxycycline and rifampin for at least 6 weeks.

• #84 Clinical Overview of Brucellosis | Brucellosis | CDC

  https://www.cdc.gov/brucellosis/hcp/clinical-overview/index.html

  However, rifampin should not be used for B. abortus RB51 infection, as that particular strain is resistant to it. Consider trimethoprim-sulfamethoxazole (TMP-SMZ) instead. […] Depending on the timing of treatment and severity of illness, recovery may take a few weeks to several months. Though the infection can last a long time, brucellosis rarely causes death. It’s estimated that no more than 2% of all people with brucellosis die from their infection.

• #85 Brucellosis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17886-brucellosis

  How is brucellosis treated? Your healthcare provider will treat brucellosis with a combination of at least two types of antibiotics. Youll need to take them for at least six to eight weeks. Depending on your specific case, you may need other therapies (like draining infected areas or managing complications). […] What medications are used to treat brucellosis? Antibiotics healthcare providers prescribe to treat brucellosis include: Streptomycin or gentamicin. Rifampin. Doxycycline. Trimethoprim/sulfamethoxazole (TMP/SMX). Ciprofloxacin. […] How can I reduce my risk of brucellosis? You can reduce your risk of brucellosis by practicing safe food handling and wearing protective clothing while working with animals, for instance: Dont drink unpasteurized milk or eat foods made with unpasteurized milk.

• #86 Clinical Overview of Brucellosis | Brucellosis | CDC

  https://www.cdc.gov/brucellosis/hcp/clinical-overview/index.html

  However, rifampin should not be used for B. abortus RB51 infection, as that particular strain is resistant to it. Consider trimethoprim-sulfamethoxazole (TMP-SMZ) instead. […] Depending on the timing of treatment and severity of illness, recovery may take a few weeks to several months. Though the infection can last a long time, brucellosis rarely causes death. It’s estimated that no more than 2% of all people with brucellosis die from their infection.

• #87 Brucellosis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17886-brucellosis

  What can I expect if I have brucellosis? Most people with brucellosis will make a full recovery with antibiotic treatment, but it can take a long time. You can expect to take antibiotics for several weeks or months to make sure all the bacteria in your body are gone. […] Can Brucella in humans be cured? Yes, Brucella infections in humans can be cured by antibiotics. However, some complications can cause lasting damage. […] Can brucellosis cause death? Its rare for someone to die of brucellosis. The fatality (death) rate from brucellosis is between 1% and 2% of all cases.

• #88 Diagnosis of human brucellosis: Systematic review and meta-analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10950246/

  This systematic review underscores the potential of the Rose Bengal test, IgG/IgM ELISA, and PCR as promising diagnostic tools for brucellosis. […] The findings highlight the pressing need for standardization, improved reporting, and ongoing advancements in test development to enhance the accuracy and accessibility of brucellosis diagnosis. […] Confirmatory diagnosis of brucellosis traditionally requires Brucella sp. isolation in culture of clinical specimens such as blood or other body fluids. […] Although widely accepted, culture isolation requires substantial time and is not generally very sensitive, especially during the later stages of the disease. […] Immunological diagnostic methods therefore became more widely used, especially the Rose Bengal test, the standard tube agglutination test (SAT), enzyme-linked immunosorbent assays (ELISA), the Coombs test, and immunochromatographic tests.

• #89 Diagnosis of human brucellosis: Systematic review and meta-analysis | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012030

  Brucellosis, a widely spread zoonotic disease, poses significant diagnostic challenges due to its non-specific symptoms and underreporting. Timely and accurate diagnosis is crucial for effective patient management and public health control. However, a comprehensive comparative review of available diagnostic tests is lacking. […] This systematic review addressed the following question: What is the accuracy of the available tests to confirm human brucellosis? […] A total of 38 studies reporting diagnostic test performance for human brucellosis were included. However, the evidence available is limited, and significant variability was observed among studies. […] This systematic review underscores the potential of the Rose Bengal test, IgG/IgM ELISA, and PCR as promising diagnostic tools for brucellosis. However, the successful implementation and recommendations for their use should consider the local context and available resources. The findings highlight the pressing need for standardization, improved reporting, and ongoing advancements in test development to enhance the accuracy and accessibility of brucellosis diagnosis.

• #90 Diagnosis of human brucellosis: Systematic review and meta-analysis | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012030

  Brucellosis, a widely spread zoonotic disease, poses significant diagnostic challenges due to its non-specific symptoms and underreporting. Timely and accurate diagnosis is crucial for effective patient management and public health control. However, a comprehensive comparative review of available diagnostic tests is lacking. […] This systematic review addressed the following question: What is the accuracy of the available tests to confirm human brucellosis? […] A total of 38 studies reporting diagnostic test performance for human brucellosis were included. However, the evidence available is limited, and significant variability was observed among studies. […] This systematic review underscores the potential of the Rose Bengal test, IgG/IgM ELISA, and PCR as promising diagnostic tools for brucellosis. However, the successful implementation and recommendations for their use should consider the local context and available resources. The findings highlight the pressing need for standardization, improved reporting, and ongoing advancements in test development to enhance the accuracy and accessibility of brucellosis diagnosis.

• #91 Laboratory Diagnostic Procedures for Human Brucellosis: An Overview of Existing Approaches

  https://brieflands.com/articles/jjm-91200

  Laboratory diagnosis of brucellosis still relies upon culture of bacteria followed by various biochemical and serological test results. […] Nucleic acid tests such as PCR are the novel-generation technologies that have higher sensitivity than blood cultures and better specificity than serologic tests. […] Molecular techniques such as PCR facilitate rapid, sensitive, and specific detection. […] Finally, it should be emphasized that novel technologies such as microfluidic lab-on-chip and next-generation sequencing (NGS) can provide a rapid, accurate, and safe diagnosis of brucellosis, especially in endemic countries.

• #92 Updated Guidelines for the Diagnosis of Human Brucellosis — China, 2019

  https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2020.129

  LFA and ELISA were cleared by the CFDA and were considered acceptable alternatives for the laboratory diagnosis of brucellosis. […] Fluorescence polarization assay seems to be a valuable method for the diagnosis of brucellosis in humans. Another option is MALDI-TOF mass spectrometry, which is revolutionizing the clinical diagnosis procedure.

• #93 Diagnosis of human brucellosis: Systematic review and meta-analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10950246/

  This systematic review underscores the potential of the Rose Bengal test, IgG/IgM ELISA, and PCR as promising diagnostic tools for brucellosis. […] The findings highlight the pressing need for standardization, improved reporting, and ongoing advancements in test development to enhance the accuracy and accessibility of brucellosis diagnosis. […] Confirmatory diagnosis of brucellosis traditionally requires Brucella sp. isolation in culture of clinical specimens such as blood or other body fluids. […] Although widely accepted, culture isolation requires substantial time and is not generally very sensitive, especially during the later stages of the disease. […] Immunological diagnostic methods therefore became more widely used, especially the Rose Bengal test, the standard tube agglutination test (SAT), enzyme-linked immunosorbent assays (ELISA), the Coombs test, and immunochromatographic tests.

• #94 Diagnosis of human brucellosis: Systematic review and meta-analysis | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012030

  Brucellosis, a widely spread zoonotic disease, poses significant diagnostic challenges due to its non-specific symptoms and underreporting. Timely and accurate diagnosis is crucial for effective patient management and public health control. However, a comprehensive comparative review of available diagnostic tests is lacking. […] This systematic review addressed the following question: What is the accuracy of the available tests to confirm human brucellosis? […] A total of 38 studies reporting diagnostic test performance for human brucellosis were included. However, the evidence available is limited, and significant variability was observed among studies. […] This systematic review underscores the potential of the Rose Bengal test, IgG/IgM ELISA, and PCR as promising diagnostic tools for brucellosis. However, the successful implementation and recommendations for their use should consider the local context and available resources. The findings highlight the pressing need for standardization, improved reporting, and ongoing advancements in test development to enhance the accuracy and accessibility of brucellosis diagnosis.

• #95 Diagnosis of human brucellosis: Systematic review and meta-analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10950246/

  The high performance observed for the Rose Bengal test could be due to a sample selection, with patients recruited during the early stages of the disease, typically within three months of symptom onset. […] The present study confirms the need for more investment in supporting both the development of new diagnostic tests and well-designed studies for brucellosis.

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