#brucellosis

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Case report (There's actually a lot of background pathophysio, investigations and treatment listed in case reports and many are free)

Brucellosis Other names: Bang’s disease, contagious abortion; undulant fever (humans); may be a cause of suppurative bursitis (fistulous withers/poll evil) in horses Cause: Brucella abortus (also caused by Brucella melitensis in some countries, especially in goats; B. melitensis is not present in the US) Species: cattle, alpacas, other ruminants and camelids, horses, humans Note: The brucellosis of dogs is caused by a different organism, and is unlikely to cause illness in humans or livestock. The brucellosis of swine is also caused by a different organism; it causes illness in humans and dogs, but typically not other livestock species. Signs: Cattle – Abortion, usually at ~5-6 months gestation (cow typically only aborts once after exposure; subsequent pregnancies normal) and temporary infertility; usually many cows in herd affected at a time (~40-80% of pregnant cows). In some cases the calves survive pregnancy but are weak and die soon after birth. Also can cause reduced milk yield and retained placentas, which leads to metritis. Hygromas, especially of the carpal joints, may develop in animals with chronic infections. Infected bulls typically asymptomatic, but sometimes develop  testicular abscesses, orchitis, epididymitis, and/or seminal vesiculitis; may be either unilateral or bilateral. Horses – Most common sign is fistulous withers or poll evil (The supraspinous or supra-atlantal bursa distends with a clear, straw-colored, viscous exudate. Secondary infection with purulent discharge and fistula formation occurs when bursa wall ruptures. If left untreated, the ligament and the dorsal vertebral spines are also  affected, and may become necrotic). Lameness due to infection of the joints and late abortions occur rarely. Humans – recurrent (undulant) fever, sweats; prolonged or recurrent malaise, anorexia, headache, pain in muscles, joints, and/or back; chronic fatigue, arthritis, orchitis, endocarditis, neurological signs (5% of cases),  depression, swelling of liver and spleen. Death occurs in up to 2% of cases. Often mistaken for malaria in areas where both diseases are endemic. Transmission: Cattle – Organisms are shed in milk and secretions from non-lactating udders (typically for life), uterine discharges (typically resolves after abortion/parturition, but not always), and are present in the aborted fetus, placenta, and other fetal membranes. Infection occurs when an uninfected animal ingests feed or water contaminated with bacteria or licks the genitals of infected herdmates. Venereal transmission is rare, but can occur. Transmission can also occur via artificial insemination with infected semen. Horses – History of exposure to infected cattle or grazing in a pasture previously occupied by infected cattle. Humans – Consuming unpasteurized/raw dairy products most common mode of transmission; inhaling aerosolized bacteria or bacterial contamination of wounds or mucous membranes (risk of this mode of transmission is greatest for slaughterhouse workers, hunters, farmers, and veterinarians). Direct transmission between humans is very rare, but can occur via breast milk, sexual intercourse, tissue transplantation or blood transfusions. **Accidental exposure to brucellosis vaccine via needle stick or by getting vaccine splashed in an eye or wound can lead to symptoms of brucellosis. ** In ideal conditions (cool, out of direct sunlight) the bacteria can remain infective in the environment for over 2 months. Diagnosis: Requires laboratory testing. Cattle – Many options available: culturing samples from the placenta, or from the stomach or lungs of the aborted fetus; milk or serum ELISA tests; serum agglutination test (standard); complement fixation, rivanol precipitation, and acidified antigen procedures. Brucella milk ring test (BRT), the brucellosis card (or rose bengal) test and plate test are useful for screening but due to high numbers of false positives, further testing is required for a definitive diagnosis. Horses – Serum agglutination titers or  isolation of B. abortus from bursa fluid. Humans – Isolation of bacteria from  blood, bone marrow, or other body fluids. Serum antibody test. Treatment: Cattle – None. Cull infected animals and retest herdmates at regular intervals until two or three successive tests are all negative. Horses – Complete surgical removal of the infected bursa. Earlier treatment results in a better prognosis; treatment of chronic cases often cost-prohibitive.  Sodium iodide therapy is usually unhelpful. Humans – Antibiotics (usually doxycyxline or rifampin) for a minimum of 6-8 weeks. Recovery can take up to several months. Prevention: Cattle – Protect brucellosis-free herds!! Any replacement animals from outside the herd should be vaccinated calves or adults that originate from brucellosis-free areas or herds and be seronegative. Replacements should be isolated for ~30 days and retested before being added to the herd. Vaccination, especially of calves, with B. abortus Strain RB51. Vaccination increases resistance but some vaccinated cattle may still become infected. For this reason, avoid vaccination with B. abortus Strain 19 if possible, as this vaccine may cause persistent antibodies that confuse diagnostic tests (not an issue with B. abortus Strain RB51 vaccine). Strain 19 may also cause orchitis or hygromas. Practice good environmental management, including cleaning and disinfecting all cattle premises which may be contaminated with B. abortus and burning/burying all contaminated fetuses, fetal membranes, etc. Horses – Do not graze with cattle or on pastures previously used to graze cattle. Vaccination ineffective. Humans – Do not consume raw/unpasteurized dairy products! Wear PPE when handling animal tissues or infected animals (rubber gloves, goggles, gowns or aprons). **If accidental exposure to the vaccine occurs, follow CDC guidelines here https://www.cdc.gov/brucellosis/veterinarians/rb51-reduce-risk.html ** Note: This is a reportable disease! Brucellosis has been eradicated from cattle herds in the USA, but brucellosis is endemic in some nondomesticated bison and elk herds in the USA. While transmission of Brucellosis from wild ruminants to domestic cattle is rare, it has occurred in the area around  Yellowstone Park. Brucellosis remains endemic in cattle in most other countries. Sources: Blackwell's Five-Minute Veterinary Consult: Canine and Feline, Merck Veterinary Manual, horsedvm.com (image of horse), CDC, Purdue University, African Veterinary Information Portal (images of fetus and higromas), Infonet-Biovision (image of retained placenta)

Hello everyone! 🙋 This week was SUPER busy. We made an other coproparacitology exam and gues what i foud?! You can see it in the first image, it's a nematode called Trichostrongylus they are very common in herbivores like cows, sheeps, rabbits 🐰... Second imagen: we made a C.brucelle test afortunately the result was negative Third and fourth images are from a echocardiogram of my dog. Was my firts time seeing a doppler echocardiography. The use of doppler technology allows you to determinante the speed and direction of blow flow and you can see it in black and white or in color. And the last images are from me studing... It's getting scary... We are close to exam season 😱

Canine Brucellosis Other names: Contagious canine abortion Cause: Brucella canis Note: Dogs can also be infected with the Brucellosis of swine, Brucella suis, which I've already done a write-up on. Species: Dogs, humans (rare; dog breeders and veterinarians at highest risk. Average pet owners not considered at risk unless immune compromised) Note: Beagles most commonly infected in the USA. In the USA rates of infection highest in the rural South. Also seen in Mexico, Japan, China, Tunisia, and several countries in South America and Europe. Signs: Dogs -- May appear healthy or only have vague signs of illness, especially females. Abortion (typically at 6-8  weeks gestation, but may occur at any time in the pregnancy), followed by vaginal discharge for several weeks. If pups survive pregnancy, they may be born weak and die, be asymptomatic carriers and later develop disease, or be uninfected. Unilateral or bilateral scrotal swelling and epididymitis, testicular atrophy, scrotal dermatitis. Decreased semen quality (decreased motility, increased immature sperm cells, inflammatory cells; aspermia without inflammatory cells if bilateral testicular atrophy present). Necrosis of the prostate parenchyma and seminiferous tubules. Males may shed bacteria for years. Both sexes may show infertility, anterior uveitis, retinitis, lethargy, loss of libido, granulometous lesions in genitourinary organs, swollen lymph nodes, splenomegaly, premature aging, spinal pain, diskospondylitis, posterior weakness, and ataxia. Humans -- Rare and usually mild (undulant fever, headache, weakness, malaise, and lymph node enlargement). In severe cases, joints, bones, and heart valves may be affected. Signs usually develop 3-4 weeks after exposure, but can occur as soon as 1 week or as long as several months. Transmission: Dogs -- nose/oral contact with reproductive discharges from an infected female when she is in heat, after an abortion, or during birth. Can also be transmitted via semen or urine. Puppies can be infected in utero. Humans -- Via contact of birthing fluids, fetal membranes, aborted fetuses, or vaginal discharges with mucous membranes or skin wounds. There is also a risk of exposure through feces, urine, and nasal secretions, though it is lower. Note: Like other Brucella species, this organism can remain infectious for several months in ideal environmental conditions (high humidity, low temperature, out of direct sunlight), so contaminated dust/dirt, water, clothing, and other fomites also pose a risk. Diagnosis: Dogs -- Serologic testing (high rate of false positives, unlike with other Brucella species) including RSAT, ELISA, cell wall antigen test, soluble antigen test (most accurate and recommended), mercaptoethanol tube agglutination test. Culture of organism from blood, vaginal fluids, semen, urine, or lymph node aspirate. Diskospondylitis on radiographs can indicate Brucellosis but is not diagnostic. Humans -- Blood culture prior to antibiotic therapy. Current serologic tests for Brucella species do not detect B. canis Treatment: Dog - Short of euthanasia, no method of control is guaranteed to be effective. Owners have an ethical obligation to reduce the risk of transmitting infection to humans or other dogs; this means not breeding infected dogs or selling/rehoming infected dogs (including pups that may have been infected in utero), and limiting contact with infected dogs to as few people as possible. Treatment is expensive and outcome is uncertain as some dogs do not clear the infection even with treatment, especially males due to persistent prostatic infections. Treatment is NOT recommended for breeding dogs; if euthanasia is unacceptable, spay/neuter as part of treatment. No single antibiotic regimen has reliable results. Most successful is a combination of a tetracycline or doxycyxline and dihydrostreptomycin for 4 weeks. Enrofloxacin and gentamicin have been tried, with mixed results (close monitoring of renal function necessary with gentamicin). Patient should be retested monthly for at least 3 months after antibiotic treatment is completed until they test negative. Relapses common; in these cases retreat or euthanize. Confine and isolate infected dogs to prevent the spread of the disease. Prognosis is best with acute infections and worst with chronically infected males. Successfully treated dogs are fully susceptible to reinfection. Humans -- Typically doxycyxline and rifampin in combination for 6-8 weeks, but other protocols also used. Prevention: Dogs -- No vaccine available. Purchase only dogs from reputable breeders. Test all brood bitches before they come into heat. Frequently test all males used for breeding. Quarantine and test all new dogs, only introduce to pack or breeding kennel when animal has had two negative tests a month apart. Practice good sanitation of all kennels, yards, etc. and line with pea rocks or concrete to prevent contamination of mud and dirt. Dry contaminated hard surfaces and disinfect with bleach. Launder contaminated blankets or burn. Do not take infected dogs to areas where they may contact people or other dogs, such as dog parks, beaches, or working/hunting trials or dog shows. DO NOT BREED INFECTED DOGS! Humans -- Use gloves when assisting with whelping or cleaning up urine, feces, reproductive tissues, or disposing of aborted fetuses. Wear facemasks and eye protection when spraying out kennels to prevent aerosolized bacteria from contacting your mouth or eyes. Practice good hygiene. Launder contaminated clothing. Limit contact of infected dogs to as few people as possible, and do not allow them to lick or mouth people.  Do not sell or rehome infected dogs. Sources: Blackwell's Five-Minute Veterinary Consult: Canine and Feline, Vetbook (images), Wisconsin Department of Health Services Division of Public Health, VCA, WebMD

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