Clinical spectrum, susceptibility profile, treatment and outcome of culture-confirmed brucellosis from South India
Loading...
Date
2018-06
Journal Title
Journal ISSN
Volume Title
Publisher
Indian Association of Medical Microbiologists
Abstract
Brucellosis, a common zoonosis, is under reported in India despite its endemicity and increased exposure to livestock among the population. This study was conducted to determine the clinical manifestations, antibiotic susceptibility pattern, treatment and outcome of culture confirmed brucellosis. Adult patients with culture confirmed brucellosis who presented to a large teaching hospital in South India between 2009 and 2015 were included. A diagnosis of brucellosis was confirmed on automated culture. Clinical profile, laboratory parameters, drug susceptibility, treatment and outcome were documented by reviewing the medical records. The cohort comprised of 22 patients with mean ± SD age of 42 ± 13 years. Twenty one (95.5%) was male. Thirteen (59%) patients were from rural area and risk of acquisition of brucellosis including occupational exposure or consumption of unpasteurized milk was evident in 16 (72.7%) patients. The mean duration of symptoms before presentation was 54.5 ± 52 days. The commonest clinical presentation was prolonged fever without a definite focus in 18 patients (82%), whereas 2 (9%) patients had osteoarticular involvement and one patient (4.5%) each had genital involvement and endocarditis. Eighteen patients (82%) with uncomplicated brucellosis were treated with aminoglycoside and doxycycline for 6 weeks. There was no relapse or mortality at 18 ± 9 months of follow up. Brucellosis in this cohort had acute or subacute presentation with prolonged fever and bacteremia. High index of clinical suspicion based on significant epidemiological history along with automated blood culture improves the efficiency of diagnosis. Cure with lack of relapse among these cases suggests a combination therapy with doxycycline and aminoglycoside is highly effective for the treatment.
Description
Keywords
Brucellosis, culture, South India, zoonosis
Citation
Mani SS, Gunasekaran K, Iyyadurai R, Prakash JA, Veeraraghavan B, Mishra AK, Sabnis K, Victor PJ, Martin S, Chandiraseharan VK, Hansdak SG, Varghese GM. Clinical spectrum, susceptibility profile, treatment and outcome of culture-confirmed brucellosis from South India. Indian Journal of Medical Microbiology. 2018 Jun; 36(2): 289-292