Bruceloza
Objawy

Bruceloza to zakaźna choroba bakteryjna o szerokim spektrum klinicznym, wywoływana przez bakterie z rodzaju Brucella. Okres inkubacji jest zmienny, najczęściej 2-4 tygodnie, ale może trwać od 5 dni do 6 miesięcy. Około 50% przypadków rozwija się w formie ostrej, charakteryzującej się falującą gorączką do 40-41°C, dreszczami, nocnymi potami, bólami mięśniowo-stawowymi (55-80% pacjentów), zaburzeniami żołądkowo-jelitowymi (70%), a także objawami neuropsychiatrycznymi. Zajęcie układu nerwowego jest rzadkie, ale może prowadzić do neurobrucelozy z zapaleniem opon mózgowo-rdzeniowych i uszkodzeniem nerwów czaszkowych. Inne powikłania obejmują zapalenie wątroby (25-30%), powiększenie śledziony (20-30%), zapalenie najądrzy u mężczyzn (20%) oraz rzadkie zmiany skórne i sercowo-naczyniowe, w tym endocarditis (1%).

Objawy Brucelozy

Bruceloza to choroba zakaźna wywoływana przez bakterie z rodzaju Brucella, która może dotykać zarówno ludzi, jak i zwierzęta. Jej objawy są zróżnicowane i mogą wahać się od łagodnych do ciężkich, a ich pojawienie się jest zależne od wielu czynników, w tym gatunku bakterii, drogi zakażenia oraz stanu zdrowia pacjenta12.

Okres inkubacji

Okres inkubacji brucelozy jest bardzo zróżnicowany i może wynosić od kilku dni do nawet kilku miesięcy1. Najczęściej jednak pierwsze objawy pojawiają się w czasie od 2 do 4 tygodni po ekspozycji na bakterie12. W literaturze medycznej opisywane są również przypadki, gdy okres inkubacji wynosił od 5 dni do nawet 6 miesięcy1. Warto zaznaczyć, że u około 50% osób zakażonych bruceloza rozwija się w formie ostrej, gdy objawy pojawiają się w ciągu 12 dni od zakażenia1.

Objawy ostrej brucelozy

Początkowe objawy brucelozy są często niespecyficzne i przypominają objawy grypy, co może utrudniać prawidłową diagnozę12. Faza ostra charakteryzuje się nagłym wystąpieniem objawów, które mogą obejmować:

  • Gorączkę, często o charakterze falującym (undulant fever) – występuje u 80-100% pacjentów1
  • Dreszcze1
  • Intensywne pocenie się, szczególnie w nocy, czasem o charakterystycznym zatęchłym zapachu12
  • Bóle głowy1
  • Bóle mięśni i stawów1
  • Bóle pleców i kręgosłupa1
  • Ogólne osłabienie i zmęczenie1
  • Utratę apetytu i spadek masy ciała1
  • Zaburzenia żołądkowo-jelitowe (u około 70% pacjentów), w tym nudności, wymioty, bóle brzucha, zaparcia lub biegunkę12

Charakterystyczną cechą gorączki w brucelozie jest jej falujący przebieg – temperatura zwykle wzrasta wieczorem do 40-41°C, a następnie stopniowo spada do wartości normalnych lub prawie normalnych, czemu towarzyszy obfite pocenie się rano1. Ten falujący wzorzec gorączki jest powodem, dla którego brucelozę nazywa się również „gorączką falującą” (undulant fever)1.

Objawy ze strony układu ruchu

Jednym z charakterystycznych objawów brucelozy są dolegliwości ze strony układu mięśniowo-szkieletowego1. Występują one u 55-80% pacjentów i mogą obejmować:

  • Bóle stawów (artralgia)1
  • Zapalenie stawów (najczęściej dotyczy kolan, bioder, stawów krzyżowo-biodrowych, barków i mostkowo-obojczykowych)1
  • Zapalenie kości i szpiku (osteomyelitis), najczęściej w obrębie kręgosłupa piersiowego i lędźwiowego1
  • Bóle mięśniowe1
  • Zapalenie kręgosłupa (spondylitis)1
  • Zapalenie stawów krzyżowo-biodrowych (sacroiliitis)1

Objawy neurologiczne i neuropsychiatryczne

Mimo że bezpośrednie zajęcie układu nerwowego jest stosunkowo rzadkie, objawy neuropsychiatryczne są dość powszechne w brucelozie1. Mogą one obejmować:

  • Bóle głowy1
  • Depresję1
  • Przewlekłe zmęczenie1
  • Zaburzenia snu1
  • Osłabienie1
  • Zawroty głowy1
  • Niestabilny chód1
  • Zatrzymanie moczu1

W ciężkich przypadkach może dojść do neurobrucelozy, która manifestuje się jako zapalenie opon mózgowo-rdzeniowych, zapalenie mózgu, zapalenie rdzenia, ropnie mózgu, neuropatia obwodowa lub uszkodzenie nerwów czaszkowych1. Szczególnie charakterystyczne jest symetryczne uszkodzenie VIII nerwu czaszkowego, prowadzące do zaburzeń słuchu1.

Objawy ze strony układu pokarmowego i wątroby

Zapalenie wątroby występuje u 25-30% pacjentów, częściej w ostrej brucelozie1. Zmiany patologiczne mogą manifestować się jako zapalenie wątroby, nieserowaciejące ziarniniaki lub małe ropnie. Inne objawy ze strony układu pokarmowego obejmują:

  • Bóle brzucha1
  • Dyspepsję1
  • Nudności i wymioty1
  • Zaparcia1
  • Biegunkę1
  • Powiększenie wątroby (hepatomegalia) – występuje u do 50% pacjentów1
  • Rzadko zapalenie pęcherzyka żółciowego1

Objawy ze strony układu krwiotwórczego

Zakażenie brucellą może wpływać na układ krwiotwórczy, powodując:1

  • Powiększenie śledziony (splenomegalia) – u 20-30% pacjentów
  • Powiększenie węzłów chłonnych – u 10-20% pacjentów
  • Hiperkomórkowy szpik kostny, czasem z ziarniniakami
  • Nieprawidłowości w morfologii krwi

Objawy ze strony układu rozrodczego i moczowego

Bruceloza może powodować zakażenia układu moczowo-płciowego, które manifestują się jako:1

  • Zapalenie najądrzy i jąder (epididymo-orchitis) u mężczyzn – występuje u około 20% pacjentów płci męskiej
  • Zapalenie przydatków, zapalenie szyjki macicy i ropnie w obrębie miednicy mniejszej u kobiet
  • Śródmiąższowe zapalenie nerek, odmiedniczkowe zapalenie nerek lub kłębuszkowe zapalenie nerek

U kobiet w ciąży zakażenie brucellą zwiększa ryzyko poronienia12.

Objawy skórne

Zmiany skórne w brucelozie są stosunkowo rzadkie i występują u 2-6% pacjentów. Mogą one obejmować:1

  • Niespecyficzną drobnoplamistą lub grudkowo-plamistą wysypkę
  • Rumień guzowaty
  • Owrzodzenia skóry
  • Zapalenie naczyń

Objawy ze strony układu sercowo-naczyniowego

Bruceloza sercowo-naczyniowa jest rzadka i zazwyczaj manifestuje się jako:1

  • Zapalenie wsierdzia (endocarditis) – występuje u około 1% wszystkich przypadków brucelozy, jest najpoważniejszym powikłaniem i główną przyczyną zgonów w brucelozie1
  • Rzadziej zapalenie mięśnia sercowego lub osierdzia
  • Zapalenie błony wewnętrznej tętnic
  • Tętniaki grzybicze

Objawy oczne

Bruceloza może również powodować zmiany w obrębie narządu wzroku, takie jak:1

  • Zapalenie błony naczyniowej oka (uveitis)
  • Zapalenie tęczówki i ciała rzęskowego (iridocyclitis)
  • Zapalenie rogówki (keratitis)
  • Zapalenie nerwu wzrokowego (optic neuritis)
  • Zapalenie wnętrza gałki ocznej (endophthalmitis)

Bruceloza podostra i przewlekła

Bruceloza może przejść w formę podostrą, gdy objawy utrzymują się od 8 do 52 tygodni od początku zakażenia, lub w formę przewlekłą, gdy objawy trwają dłużej niż 52 tygodnie1. W brucelozie podostrnej początek objawów jest zwykle bardziej podstępny, z narastającym złym samopoczuciem, bólami mięśni, bólami głowy i karku, po których następuje wzrost temperatury ciała wieczorem1.

Objawy brucelozy przewlekłej

Bruceloza przewlekła charakteryzuje się nawracającymi lub utrzymującymi się objawami przez dłuższy czas, nawet po leczeniu. Objawy te mogą obejmować:12

  • Przewlekłe zmęczenie
  • Nawracające gorączki
  • Zapalenie wsierdzia
  • Zapalenie stawów
  • Zapalenie kręgów kręgosłupa (spondylitis)
  • Zapalenie stawów krzyżowo-biodrowych (sacroiliitis)
  • Depresję
  • Zaburzenia snu
  • Bóle mięśniowe
  • Czasem zaburzenia czuciowe, radikulopatie

W formie przewlekłej objawy mogą pojawiać się i znikać przez miesiące lub lata1. Nawroty choroby (relapse) występują zazwyczaj w ciągu 6 miesięcy po zakończeniu leczenia i mają łagodniejszy przebieg; nie są związane z opornością na leki1. Nawroty dotyczą około 5-10% leczonych pacjentów1.

Powikłania brucelozy

Nieleczona lub nieodpowiednio leczona bruceloza może prowadzić do poważnych powikłań, które obejmują:12

  • Przewlekłe zapalenie stawów
  • Zapalenie wsierdzia, które może uszkodzić lub zniszczyć zastawki serca
  • Zakażenie ośrodkowego układu nerwowego, w tym zapalenie opon mózgowo-rdzeniowych i zapalenie mózgu
  • Powiększenie wątroby i śledziony
  • Przewlekłe zmęczenie
  • Depresję

Ryzyko rozwoju powikłań ogniskowych wzrasta, jeśli objawy trwają dłużej niż miesiąc przed postawieniem diagnozy1. Powikłania są rzadkie, jeśli pacjent jest leczony na czas i odpowiednio, choć nawrót zakażenia może wystąpić2.

Bruceloza u dzieci

Bruceloza u dzieci zwykle powoduje łagodną do umiarkowanej chorobę i rzadko postępuje do choroby przewlekłej1. Jednak opisywane są przypadki ciężkiej brucelozy u dzieci, z szerokim spektrum objawów klinicznych1. Jednym z rzadkich, ale opisywanych zespołów u dzieci z brucelozą jest zespół niewłaściwego wydzielania hormonu antydiuretycznego (SIADH), który jest bardzo rzadkim zaburzeniem w populacji pediatrycznej1.

Bruceloza u zwierząt

Bruceloza dotyka wiele gatunków zwierząt, w tym bydło, kozy, owce, świnie, psy i dzikie zwierzęta1. Objawy u zwierząt różnią się od tych u ludzi i często dotyczą układu rozrodczego1. Najczęstsze objawy brucelozy u zwierząt to:

  • Poronienia, zwykle w 5-7 miesiącu ciąży1
  • Rodzenie słabych, niezdrowych cieląt/młodych1
  • Zmniejszona produkcja mleka1
  • Utrata masy ciała1
  • Słabe wskaźniki zapłodnienia lub bezpłodność1
  • Zatrzymanie łożyska z wynikającymi z tego zakażeniami macicy1
  • Powiększone, artretyczne stawy (okazjonalnie)1

U psów bruceloza może powodować12:

  • Zapalenie najądrzy u samców
  • Powiększone moszna lub jądro
  • Wysypkę na mosznie
  • Bezpłodność
  • Zanik jąder w przypadkach przewlekłych
  • Zakażenie macicy u samic
  • Trudności z zajściem w ciążę
  • Poronienia w późnych stadiach ciąży
  • Utrzymujący się upław z pochwy

Warto zauważyć, że zakażone zwierzęta mogą wyglądać zdrowo, nawet w czasie ciąży, ale nadal mogą przenosić i rozprzestrzeniać zakaźne bakterie i stanowić niebezpieczne źródło zakażenia1.

Rokowanie w brucelozie

Rokowanie w brucelozie jest generalnie dobre1. Mimo że początkowe objawy brucelozy mogą być wyniszczające, jeśli są odpowiednio leczone i w ciągu pierwszych kilku miesięcy od wystąpienia, choroba jest łatwo uleczalna, z niskim ryzykiem nawrotu lub choroby przewlekłej1.

Czas powrotu do zdrowia zwykle wynosi od 3 do 6 miesięcy1. W niepowikłanych przypadkach ostrej brucelozy, gorączka, złe samopoczucie i wiele innych objawów szybko ustępuje przy odpoczynku w łóżku, podczas gdy długotrwała aktywność fizyczna może przedłużyć lub pogorszyć stopień choroby1.

Śmiertelność z powodu brucelozy jest rzadka i wynosi mniej niż 2% wszystkich przypadków12. Złe rokowanie występuje u pacjentów z niewydolnością serca spowodowaną zapaleniem wsierdzia1.

Podsumowanie

Bruceloza (Bruceloza) jest chorobą o bardzo zróżnicowanym obrazie klinicznym, od zakażeń bezobjawowych do ciężkich, zagrażających życiu infekcji1. Najczęstsze objawy to gorączka, poty, bóle głowy, stawów i mięśni oraz ogólne osłabienie1. Choroba może przebiegać w formie ostrej, podostrnej lub przewlekłej, a objawy mogą utrzymywać się przez miesiące lub lata, nawet po leczeniu1.

Diagnostyka brucelozy jest trudna ze względu na niespecyficzne objawy początkowe, które mogą przypominać wiele innych chorób gorączkowych1. Wczesne rozpoznanie i odpowiednie leczenie antybiotykami jest kluczowe dla zapobiegania przewlekłym powikłaniom, takim jak zapalenie stawów, zapalenie wsierdzia, przewlekłe zmęczenie czy depresja1.

Kolejne rozdziały

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Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 15.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Brucellosis – Bacterial Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine
    https://empendium.com/mcmtextbook/chapter/B31.II.18.96.2.
    The disease has a very wide spectrum of symptoms, from asymptomatic to severe life-threatening infection. […] The clinical picture and severity of the disease depend on the bacterium species, infective dose, route of infection, and overall condition of the host, including their immune and nutrition status, diseases, and medications taken (especially antacids). […] In acute brucellosis symptoms subside 8 weeks from infection onset; in subacute brucellosis, between 8 and 52 weeks; and in chronic brucellosis, 52 weeks. The disease may be acute, acute progressing to chronic, and primarily chronic. […] All tissues and organs may be involved in both acute and chronic disease, but symptoms typically occur in the osteoarticular, nervous, circulatory, and genitourinary systems and in the liver. […] The disease onset may be sudden (acute brucellosis) or with symptoms progressing over weeks or months (chronic brucellosis). A recurrent course is typical of chronic disease (in 5%-15% of cases). Relapses usually occur within 6 months after treatment completion and have a milder course; they are not associated with drug resistance.
  • #1
    https://www.who.int/news-room/fact-sheets/detail/brucellosis
    Brucellosis typically causes flu-like symptoms, including fever, weakness, malaise and weight loss. […] The incubation period of the disease can be highly variable, ranging from 1 week to 2 months, but usually 24 weeks.
  • #1 Brucellosis
    https://www.health.ny.gov/diseases/communicable/brucellosis/fact_sheet.htm
    Brucellosis is a bacterial disease caused by the Brucella bacteria. In humans, it can cause symptoms of fever, headache, and fatigue among others. […] The initial symptoms of brucellosis include irregular fever of variable duration, headache, weakness, profuse sweating, chills, weight loss and generalized aching. Brucellosis can also cause long-lasting or chronic symptoms such as recurrent fevers, joint pain, testicular swelling, heart infections, nervous system impairment, depression, and fatigue. […] Symptoms usually appear within 2 to 4 weeks after exposure, but can begin any time between 5 days and 6 months after exposure.
  • #1 Brucellosis Causes, Symptoms, Treatment, Diagnosis
    https://www.medicinenet.com/brucellosis_facts/article.htm
    The incubation period (time between infection and the development of the disease) for brucellosis is considered to be highly variable, with a range of five days to five months, with a few patients reporting incubation periods as long as a year; the average incubation period is about two to four weeks.
  • #1 Brucellosis: Definition, transmission, and treatment
    https://www.medicalnewstoday.com/articles/brucellosis
    Brucellosis is an infectious disease that causes flu-like symptoms, and it can spread from animals to humans. Without treatment, brucellosis can lead to serious complications. […] The symptoms of brucellosis may develop over days, weeks, or months. The specific symptoms depend partly on the organs and tissues affected. […] Around 50% of people with the infection develop acute brucellosis, in which case the symptoms begin within 12 days. In a person with subacute brucellosis, the symptoms take weeks to develop. When the disease is chronic, the symptoms last longer than 1 year, with repeated episodes of fever. […] The initial symptoms of brucellosis are similar to those of the flu. They can include: a fever, excessive sweating, joint pain, muscle aches and weakness, a cough, a headache, tiredness, constipation, appetite loss, weight loss, and less often: swollen lymph nodes, spleen enlargement, liver enlargement.
  • #1 Clinical Overview of Brucellosis | Brucellosis | CDC
    https://www.cdc.gov/brucellosis/hcp/clinical-overview/index.html
    Brucellosis is generally characterized by one or more of the following symptoms: […] Brucellosis in people cannot be diagnosed by clinical symptoms alone as initial symptoms are non-specific and can vary between patients. […] 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. […] 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.
  • #1 Brucellosis Clinical Presentation: History, Physical Examination, Complications
    https://emedicine.medscape.com/article/213430-clinical
    Symptoms of brucellosis are protean in nature, and none is specific enough to support the diagnosis. […] Fever is the most common symptom and sign of brucellosis, occurring in 80-100% of cases. It is intermittent in 60% of patients with acute and chronic brucellosis and undulant in 60% of patients with subacute brucellosis. […] Constitutional symptoms of brucellosis include anorexia, asthenia, fatigue, weakness, malaise, and weight loss, and these are very common (90% of cases). […] Bone and joint symptoms include arthralgias, low back pain, spine and joint pain, and, rarely, joint swelling. These symptoms affect as many as 55-80% of patients. […] Neuropsychiatric symptoms of brucellosis are common despite the rare involvement of the nervous system. Headache, depression, and fatigue are the most frequently reported neuropsychiatric symptoms.
  • #1 Brucellosis | UM Health-Sparrow
    https://www.uofmhealthsparrow.org/departments-conditions/conditions/brucellosis
    Symptoms of brucellosis may include fever, joint pain and being very tired. […] Symptoms of brucellosis may show up anytime from a few days to a few months after infection. Symptoms are like those of the flu. They include: Fever. Chills. Loss of appetite. Heavy sweating. Weakness. Tiredness. Joint, muscle and back pain. Headache. […] Brucellosis symptoms may disappear for weeks or months and then return. Some people have long-term, called chronic, brucellosis. They have symptoms for years, even after treatment. Long-term symptoms may include: Tiredness. Repeated fevers. Swelling, called inflammation, of the inner lining of the heart chambers, called endocarditis. Joint inflammation, called arthritis. Arthritis of the spinal bones, called spondylitis. Arthritis of joints where the spine and pelvis connect, called sacroiliitis.
  • #1 Brucellosis – Wikipedia
    https://en.wikipedia.org/wiki/Brucellosis
    Symptoms include fever, chills, loss of appetite, sweats, weakness, fatigue, joint pain, muscle pain, back pain, headache. […] The symptoms are like those associated with many other febrile diseases, but with emphasis on muscular pain and night sweats. The duration of the disease can vary from a few weeks to many months or even years. […] In the first stage of the disease, bacteremia occurs and leads to the classic triad of undulant fevers, sweating (often with a characteristic foul, moldy smell sometimes likened to wet hay), and migratory arthralgia and myalgia (joint and muscle pain). […] Gastrointestinal symptoms occur in 70% of cases and include nausea, vomiting, decreased appetite, unintentional weight loss, abdominal pain, constipation, diarrhea, an enlarged liver, liver inflammation, liver abscess, and an enlarged spleen. […] The consequences of Brucella infection are highly variable and may include arthritis, spondylitis, thrombocytopenia, meningitis, uveitis, optic neuritis, endocarditis, and various neurological disorders collectively known as neurobrucellosis.
  • #1 Brucellosis – MN Dept. of Health
    https://www.web.health.state.mn.us/diseases/brucellosis/brucellosis.html
    Brucellosis is a disease, caused by bacteria, which affects many different kinds of animals including sheep, goats, cattle, deer, elk, pigs, and dogs. However, it can also cause a disease with flu-like symptoms in humans. People with brucellosis may develop fever, sweats, headaches, back pains, and physical weakness. In severe cases, the central nervous system and the lining of the heart may be affected. One form of the illness may also cause long-lasting symptoms, including recurrent fevers, joint pain, and fatigue. Symptoms can appear anywhere from five to 60 days after exposure. […] Although brucellosis can make you very sick, it is rarely fatal. […] Brucellosis can be treated with antibiotics but it can take a long time, and treatment can be difficult. Depending on the severity of the illness and when treatment is begun it can take anywhere from a few weeks to a few months to recover.
  • #1 Brucellosis: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/213430-overview
    After ingestion by phagocytes, about 15-30% of brucellae survive. […] Brucellae that survive are transported into the lymphatic system and may replicate there locally; they also may replicate in the kidney, liver, spleen, breast tissue, or joints, causing both localized and systemic infection. […] Development of cell-mediated immunity is the principal mechanism of recovery. […] The prognosis generally is excellent. […] Although initial symptoms of brucellosis may be debilitating, if they are treated appropriately and within the first few months of onset, the disease is easily curable, with a low risk for relapse or chronic disease. […] In uncomplicated cases of acute brucellosis, fever, malaise, and many other manifestations improve rapidly with bed rest, whereas sustained physical activity may prolong or worsen the degree of illness. […] Recurrence of symptoms of acute brucellosis is not uncommon. The recurrent disease may be systemic or localized. […] Chronic brucellosis may continue to trouble patients for as long as 25 years, but such cases are quite rare.
  • #1 Brucellosis: Causes, Symptoms, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/17886-brucellosis
    Symptoms can come and go for a long time and include fever, joint pain and sweating. […] Symptoms of brucellosis take two to four weeks or longer to appear after you’re exposed to the bacteria. Symptoms can come and go for months or years, including: Fever. Sweating (sometimes with a moldy smell). Joint pain, especially in your hips, knees or lower back. Unexplained weight loss. Headache. Abdominal (stomach) pain. Loss of appetite or upset stomach. Depression. Large, painful lymph nodes. Generally feeling unwell. […] 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. […] Sometimes, brucellosis can come back after you’ve finished treatment, especially if you don’t take antibiotics long enough. Some symptoms, like arthritis, can last a long time, even after you finish treatment. You may need additional medications or therapies if you have complications of brucellosis.
  • #1 Brucellosis Clinical Presentation: History, Physical Examination, Complications
    https://emedicine.medscape.com/article/213430-clinical
    A significant percentage (approximately 50%) of patients have gastrointestinal (GI) complaints, primarily dyspepsia, though abdominal pain from hepatic abscesses may occur. […] Genitourinary infections with brucellae have been reported and include orchitis, urinary tract infection (UTI), and glomerulonephritis. […] Neurologic symptoms of brucellosis can include weakness, dizziness, unsteady gait, and urinary retention. […] Cough and dyspnea develop in up to 19% of persons with brucellosis; however, these symptoms are rarely associated with active pulmonary involvement. […] With the chronic form of brucellosis, in which the illness has lasted longer than 1 year (undiagnosed and untreated brucellosis), an afebrile pattern is typical, with a history of myalgia, fatigue, depression, and arthralgias.
  • #1 Brucellosis – Infectious Diseases – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/infectious-diseases/gram-negative-bacilli/brucellosis
    Symptoms begin as an acute febrile illness with few or no localized signs and may progress to a chronic stage with relapses of fever, weakness, sweats, and vague aches and pains. […] Onset may be sudden, with chills and fever, severe headache, joint and low back pain, malaise, and occasionally diarrhea. Or onset may be insidious, with mild prodromal malaise, muscle pain, headache, and pain in the back of the neck, followed by a rise in body temperature in the evening. […] As the disease progresses, temperature increases to 40 to 41 C, then subsides gradually to normal or near-normal with profuse sweating in the morning. […] Typically, intermittent fever persists for 1 to 5 weeks, followed by a 2- to 14-day remission when symptoms are greatly diminished or absent. In some patients, fever may be transient. In others, the febrile phase recurs once or repeatedly in waves (undulations) and remissions over months or years and may manifest as fever of unknown origin.
  • #1 Brucellosis: MedlinePlus Medical EncyclopediaLock
    https://medlineplus.gov/ency/article/000597.htm
    Brucellosis is a bacterial infection that occurs from contact with animals carrying brucella bacteria. […] Acute brucellosis may begin with mild flu-like symptoms, or symptoms such as: Abdominal pain, Back pain, Fever and chills, Excessive sweating, Fatigue, Headache, Joint and muscle pain, Loss of appetite, Swollen glands, Weakness, Weight loss. […] High fever spikes often occur every afternoon. The name undulant fever is often used to describe this disease because the fever rises and falls in waves. […] The illness may be chronic and last for years. […] Symptoms may come and go for years. Also, the illness can come back after a long period of not having symptoms.
  • #1 Brucellosis – Bacterial Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine
    https://empendium.com/mcmtextbook/chapter/B31.II.18.96.2.
    2) Lesions in the locomotor system are typically seen in chronic brucellosis. Arthritis involving single or multiple joints is observed, typically in the knee, hip, sacroiliac joint, shoulder, and sternoclavicular joint, and may be accompanied by osteomyelitis, most often in the thoracic and lumbar spine. The arthritis is degenerative and proliferative, with osteophyte formation. […] 3) Hepatitis occurs in 25% to 30% of patients, more often in acute brucellosis. Pathologic lesions may manifest as hepatitis, noncaseous granulomas, or minor abscesses. Cholecystitis develops rarely. […] 4) Abnormalities of the hematopoietic system: Enlargement of the spleen (20%-30% of cases) and lymph nodes (10%-20%); hypercellular bone marrow; sometimes granulomas. Abnormal complete blood count. […] 5) Nervous system infection (neurobrucellosis) may manifest as lymphocytic meningitis and/or encephalitis, myelitis, brain and epidural abscesses, peripheral neuropathy, cranial nerve damage, symmetric damage of the cranial nerve VIII (with symptoms of hearing impairment at frequencies 1000 Hz).
  • #1 Brucellosis – Bacterial Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine
    https://empendium.com/mcmtextbook/chapter/B31.II.18.96.2.
    Symptoms: […] 1) Acute brucellosis: Fever, severe weakness, myalgia, arthralgia, hyperhidrosis; sometimes gastrointestinal disorders; testicular pain in men. […] 2) Chronic brucellosis: Most frequently locomotor symptoms, myalgia; sometimes sensory deficits, radiculopathies. Patients report weakness, eating disorders, and/or excessive sweating. Psychiatric disorders, sleeping disorders, headache, and/or symmetric hearing disorders may develop. Symptoms of orchitis and/or potency disorders may be seen in men and menstruation disorders in women. Approximately 25% of patients report cough. […] Some symptoms may occur in both acute and chronic brucellosis: […] 1) Fever: Most patients (80%-100% of cases) have high-grade fever, typically with a wavy or irregular pattern and often with chills. Relative bradycardia is observed despite the fever; hypotension may occur. Due to the absence of pathognomonic symptoms, brucellosis is a frequent cause of fever of unknown origin (FUO) and neutropenic fever in endemic areas.
  • #1 Brucellosis – Infectious Diseases – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/infectious-diseases/gram-negative-bacilli/brucellosis
    After the initial febrile phase, anorexia, weight loss, abdominal and joint pain, headache, backache, weakness, irritability, insomnia, depression, and emotional instability may occur. Constipation is usually pronounced. Splenomegaly appears, and lymph nodes may be slightly or moderately enlarged. Up to 50% of patients have hepatomegaly. […] Most patients recover in 2 to 3 weeks, even without treatment, but some develop subacute, intermittent, or chronic disease.
  • #1 Brucellosis – Bacterial Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine
    https://empendium.com/mcmtextbook/chapter/B31.II.18.96.2.
    6) Genitourinary system infection: Epididymo-orchitis in men (~20%); adnexitis, cervicitis, and abscesses in the lesser pelvis in women. Infected pregnant women are at risk of miscarriage. Interstitial nephritis, pyelonephritis, or glomerulonephritis may develop. […] 7) Skin lesions: Nonspecific fine macular or maculopapular rash, erythema nodosum, skin ulceration, or vasculitis occur in 2% to 6% of cases. […] 8) Cardiovascular brucellosis is rare and usually manifests as endocarditis (1% of all brucellosis cases) and rarely as myocarditis or pericarditis, arterial intima inflammation, and/or mycotic aneurysms. […] 9) Ocular lesions: Uveitis, iridocyclitis, keratitis, optic neuritis, endophthalmitis.
  • #1
    https://www.health.nsw.gov.au/Infectious/factsheets/Pages/brucellosis.aspx
    Brucellosis typically begins with a flu-like illness. This may include fever, headache, weakness, drenching sweats, chills, weight loss, joint and muscle pain, and generalised aches. Inflammation of the liver and spleen, and gastrointestinal or respiratory symptoms may also occur. In males, the testicles may become inflamed. Rarely, the valves inside the heart may become infected and this can be fatal. […] The symptoms usually start 5-60 days after a person has been infected. […] The infection typically lasts for days or months but can occasionally last for a year or more and may recur. Disease may be mild and some people get no symptoms of infection. […] Pregnant women and their babies are at risk of developing severe disease. If left untreated, infection may cause birth defects, spontaneous abortion or fetal death.
  • #1 Brucellosis: Causes, Symptoms, and Effective Treatments | ER of Mesquite
    https://erofmesquite.com/blog/brucellosis-causes-symptoms-treatments/
    With antibiotic therapy, the majority of brucellosis patients will fully recover, however, it may take some time. […] After therapy is complete, Bangs Disease can recur occasionally, particularly if you don’t take antibiotics for a long enough time. Even when therapy is completed, some symptoms, such as arthritis, may persist for a very long time. […] Nearly every organ in the body, including the liver, heart, central nervous system, and reproductive system, can be impacted by Bangs Disease. Problems with chronic brucellosis might affect one organ at a time or the entire body. Among the potential issues are: Arthritis. Pain, stiffness, and swelling in the joints […] Endocarditis, or inflammation of the heart’s inner lining. One of the most dangerous side effects of Undulant Fever is this. Untreated endocarditis is the main cause of mortality from brucellosis and can harm or destroy the heart valves. […] Infections of the central nervous system. These include potentially fatal diseases like encephalitis, which is an inflammation of the brain, and meningitis, which is an infection of the membranes protecting the brain and spinal cord.
  • #1 Brucellosis
    https://dermnetnz.org/topics/brucellosis
    Brucellosis is an infection caused by bacteria of the genus Brucella. The incubation period of brucellosis is generally 18 weeks. Symptoms are variable and non-specific. Brucellosis can be an acute illness (abrupt onset, short duration) or symptoms may be chronic (long-lasting). Most patients have 'flu-like symptoms, such as fever, malaise, loss of appetite, muscle aches, sweats, and joint aches. The infection may spread to the central nervous system causing depression, headache, and irritability or, in advanced cases, meningoencephalitis. The infection may also spread to the inner lining of the heart and heart valves; this is called endocarditis and occurs in approximately 2% of patients. Other complications include epididymo-orchitis (inflammation of the epididymis and/or testis), granulomatous hepatitis (clumps of inflammatory cells in the liver), and arthritis. Death from brucellosis is rare, and usually results from meningoencephalitis or endocarditis. […] Relapse of infection occurs in up to 10% of patients, even with appropriate treatment.
  • #1 Brucellosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441831/
    Brucellosis is an infectious disease caused by Brucella species. […] Symptoms of brucellosis include a headache, cyclical fever, migratory arthralgia, myalgia, asthenia, anorexia, fatigue, malaise, weakness, sweating, vomiting, diarrhea, abdominal pain, and miscarriage. […] The incubation period may be as few as three days or as long as several weeks. […] Symptoms frequently last for several months, and chronic infections with brucellosis may last for years. […] The overall risk of relapse is very low. […] The prognosis is poor in patients who present with congestive heart failure due to endocarditis. […] The recovery usually takes 3-6 months. […] Complications are rare if the patient is treated timely and appropriately, though relapse of infection may occur. […] The risk for the development of focal complications increases if symptom duration is greater than one month before diagnosis.
  • #1 Presentation of severe brucellosis in 5-year-old boy – challenges and results | BMC Infectious Diseases | Full Text
    https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-023-08138-7
    It should be underlined that childhood brucellosis usually produces mild to moderate disease and rarely progresses to chronic disease. […] Despite variety of clinical signs in our patient, most of them were nonspecific and even with a huge number of different diagnostic methods the diagnosis couldn’t be verified for more than 18 months. […] One of unexplainable syndrome was SIADH which is a very rare disorder in pediatric population, but it is described in infections of the central nervous system like meningitis, encephalitis and abscess with an unclear mechanisms. […] Neurobrucellosis is serious complication of systemic brucellosis infection with a reported incidence as 0,5-25% in the post antibiotic era. Usually, neurobrucellosis is diagnosed in chronic stage of disease but it can be presenting manifestation.
  • #1 Presentation of severe brucellosis in 5-year-old boy – challenges and results | BMC Infectious Diseases | Full Text
    https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-023-08138-7
    Brucellosis is highly contagious zoonotic bacterial disease caused by gram-negative genus. It has a wide spectrum of clinical manifestations and due to variety and nonspecificity of clinical signs the diagnostics can be very complicated. […] Brucellosis exhibits variable clinical and laboratory characteristics that can mimic other infectious and non-infectious conditions. […] SIADH with hyponatremia, being very rare disorder in children, is described in association with Brucellosis and can be used as a hint for clinical diagnosis. […] Even when patients are adequately treated, relapses of the disease, usually milder than the initial episode, as well as progression to chronic phase of infection may occur. […] Our case demonstrates brucellosis infection with a wide-range clinical spectrum and severe illness.
  • #1 Disease Alert: Bovine BrucellosisLockBack to top
    https://www.aphis.usda.gov/livestock-poultry-disease/cattle/bovine-brucellosis
    Brucellosis (also known as contagious abortion or Bang’s disease) is a costly disease of livestock and wildlife. It is caused by a group of bacteria in the genus Brucella. The disease has significant consequences for animal health, public health, and international trade. […] Brucellosis occurs mainly in cattle, bison, and swine, but can affect other animals (cervids, goats, sheep, and horses) and people. […] When signs do appear, they’re most obvious in pregnant animals. Here’s what to look for: Abortion (usually at 5–7 months of pregnancy), Birth of weak, unhealthy calves, Decreased milk production, Weight loss, Poor conception rates or infertility, Retained afterbirths with resulting uterine infections, Enlarged, arthritic joints (occasionally). […] Note: Appearance alone isn’t an effective way to detect brucellosis. Infected animals may appear healthy, even during pregnancy. However, they can still harbor and spread infectious bacteria and serve as dangerous sources of infection.
  • #1 Brucellosis in Dogs | VCA Animal Hospitals
    https://vcahospitals.com/know-your-pet/canine-brucellosis
    Male dogs infected with brucellosis develop epididymitis, an infection in part of the testicle. A dog with a newly acquired infection will often have an enlarged scrotum or an enlarged testicle and may have a skin rash on the scrotum. The dog may be infertile. In chronic or long-standing cases, the testicles will atrophy or become shrunken. […] Female dogs infected with brucellosis develop an infection of the uterus. This may cause her to be infertile, have difficulty getting pregnant, or she may abort in the late stages of pregnancy. She often has a persistent vaginal discharge. Typically, a pregnant dog with brucellosis will abort at 45-55 days of gestation or will give birth to stillborn or weak puppies that may die a few days after birth. […] During the early stages of brucellosis, enlarged lymph nodes are sometimes seen, although fever is uncommon. Occasionally, B. canis will infect the intervertebral discs, eyes, kidneys, heart or brain. If the bacteria infects these other tissues, the signs will be related to the bodily system that is infected.
  • #2 Brucellosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441831/
    Brucellosis is an infectious disease caused by Brucella species. […] Symptoms of brucellosis include a headache, cyclical fever, migratory arthralgia, myalgia, asthenia, anorexia, fatigue, malaise, weakness, sweating, vomiting, diarrhea, abdominal pain, and miscarriage. […] The incubation period may be as few as three days or as long as several weeks. […] Symptoms frequently last for several months, and chronic infections with brucellosis may last for years. […] The overall risk of relapse is very low. […] The prognosis is poor in patients who present with congestive heart failure due to endocarditis. […] The recovery usually takes 3-6 months. […] Complications are rare if the patient is treated timely and appropriately, though relapse of infection may occur. […] The risk for the development of focal complications increases if symptom duration is greater than one month before diagnosis.
  • #2 Brucellosis: Causes, Symptoms, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/17886-brucellosis
    Symptoms can come and go for a long time and include fever, joint pain and sweating. […] Symptoms of brucellosis take two to four weeks or longer to appear after you’re exposed to the bacteria. Symptoms can come and go for months or years, including: Fever. Sweating (sometimes with a moldy smell). Joint pain, especially in your hips, knees or lower back. Unexplained weight loss. Headache. Abdominal (stomach) pain. Loss of appetite or upset stomach. Depression. Large, painful lymph nodes. Generally feeling unwell. […] 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. […] Sometimes, brucellosis can come back after you’ve finished treatment, especially if you don’t take antibiotics long enough. Some symptoms, like arthritis, can last a long time, even after you finish treatment. You may need additional medications or therapies if you have complications of brucellosis.
  • #2 Brucellosis | UM Health-Sparrow
    https://www.uofmhealthsparrow.org/departments-conditions/conditions/brucellosis
    Symptoms of brucellosis may include fever, joint pain and being very tired. […] Symptoms of brucellosis may show up anytime from a few days to a few months after infection. Symptoms are like those of the flu. They include: Fever. Chills. Loss of appetite. Heavy sweating. Weakness. Tiredness. Joint, muscle and back pain. Headache. […] Brucellosis symptoms may disappear for weeks or months and then return. Some people have long-term, called chronic, brucellosis. They have symptoms for years, even after treatment. Long-term symptoms may include: Tiredness. Repeated fevers. Swelling, called inflammation, of the inner lining of the heart chambers, called endocarditis. Joint inflammation, called arthritis. Arthritis of the spinal bones, called spondylitis. Arthritis of joints where the spine and pelvis connect, called sacroiliitis.
  • #2 Brucellosis – Wikipedia
    https://en.wikipedia.org/wiki/Brucellosis
    Symptoms include fever, chills, loss of appetite, sweats, weakness, fatigue, joint pain, muscle pain, back pain, headache. […] The symptoms are like those associated with many other febrile diseases, but with emphasis on muscular pain and night sweats. The duration of the disease can vary from a few weeks to many months or even years. […] In the first stage of the disease, bacteremia occurs and leads to the classic triad of undulant fevers, sweating (often with a characteristic foul, moldy smell sometimes likened to wet hay), and migratory arthralgia and myalgia (joint and muscle pain). […] Gastrointestinal symptoms occur in 70% of cases and include nausea, vomiting, decreased appetite, unintentional weight loss, abdominal pain, constipation, diarrhea, an enlarged liver, liver inflammation, liver abscess, and an enlarged spleen. […] The consequences of Brucella infection are highly variable and may include arthritis, spondylitis, thrombocytopenia, meningitis, uveitis, optic neuritis, endocarditis, and various neurological disorders collectively known as neurobrucellosis.
  • #2 Brucellosis – Knowledge @ AMBOSS
    https://www.amboss.com/us/knowledge/brucellosis/
    Brucellosis typically manifests with flu-like symptoms. Other possible symptoms include hepatomegaly, splenomegaly, lymphadenopathy, and, rarely, focal organ infection (e.g., osteomyelitis, endocarditis, spondylitis). […] General: Flu-like symptoms, Night sweats, High, potentially undulant fever, Painful lymphadenopathy, Hepatomegaly, Splenomegaly. […] Brucellosis in pregnancy can cause spontaneous abortion, preterm labor, and stillbirth. […] Brucellosis manifests as UNdulant fever and the causative pathogen is transmitted by UNpasteurized dairy products. […] Diagnosing brucellosis can be challenging due to nonspecific symptoms and potential to impact any organ. […] Life-threatening infections require prolonged treatment (e.g., 46 months) with three antibiotics. […] Brucellosis in pregnancy can cause miscarriage, preterm delivery, and stillbirth.
  • #2 Brucellosis: Causes, Symptoms, and Effective Treatments | ER of Mesquite
    https://erofmesquite.com/blog/brucellosis-causes-symptoms-treatments/
    With antibiotic therapy, the majority of brucellosis patients will fully recover, however, it may take some time. […] After therapy is complete, Bangs Disease can recur occasionally, particularly if you don’t take antibiotics for a long enough time. Even when therapy is completed, some symptoms, such as arthritis, may persist for a very long time. […] Nearly every organ in the body, including the liver, heart, central nervous system, and reproductive system, can be impacted by Bangs Disease. Problems with chronic brucellosis might affect one organ at a time or the entire body. Among the potential issues are: Arthritis. Pain, stiffness, and swelling in the joints […] Endocarditis, or inflammation of the heart’s inner lining. One of the most dangerous side effects of Undulant Fever is this. Untreated endocarditis is the main cause of mortality from brucellosis and can harm or destroy the heart valves. […] Infections of the central nervous system. These include potentially fatal diseases like encephalitis, which is an inflammation of the brain, and meningitis, which is an infection of the membranes protecting the brain and spinal cord.
  • #2 Symptoms of Brucellosis in Dogs – Chimacum Valley Veterinary Hospital
    https://chimacumvet.com/blog/symptoms-of-brucellosis-in-dogs/
    Brucellosis in dogs is a bacterial infection that can have serious implications for your pet’s health. This contagious disease is caused by the Brucella bacteria and can affect dogs of all ages. Understanding the symptoms of brucellosis in dogs is crucial for early detection and effective treatment. […] Brucellosis in dogs can present a variety of symptoms, many of which are related to the reproductive system. However, the bacteria can also affect other parts of the body, leading to a wide range of clinical signs. […] One of the most notable symptoms of brucellosis in dogs is reproductive problems. Infected male dogs may experience swollen testicles, inflammation of the prostate, and decreased fertility. Female dogs may suffer from miscarriages, stillbirths, or the birth of weak puppies. Repeated breeding failures can also be a sign of brucellosis in dogs.
  • #2 About Brucellosis | Brucellosis | CDC
    https://www.cdc.gov/brucellosis/about/index.html
    Brucellosis can cause a range of signs and symptoms in people, and some can occur for a long time before it’s diagnosed. The first symptoms can include: […] Other symptoms may continue or may come and go until you’ve had treatment, including: […] If you’re not properly treated, the infection can become chronic and lead to long-term disease associated with arthritis, endocarditis, chronic fatigue, depression, and swelling of the liver or spleen. […] Depending on the timing of treatment and how sick you are, recovery may take a few weeks to several months. Death from brucellosis is rare and only happens in less than 2% of cases.