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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 46

False a. is caused by a Gram positive bacillus
True b. causes spondylitis
True c. is treated with tetracycline
True d. is a recognised cause if chronic depression
True e. is contracted from unpasteurised milk

The causative organism is a Gram negative bacillus: Brucella abortus (from cows), Brucella suis (from pigs) and Brucella militensis (from goats)
Transmission is by oral ingestion of unpasteurised dairy produce. Inhalation of organisms is also an important mode of transmission amongst those dealing with livestock. The incubation period is about 1-3 weeks but may be much longer.

Clinical presentation. The disease may present non-specifically and some complications may arise months after infection.

Table 46.1

Common presenting features of brucellosis
body pains
positive exposure history

Table 46.2

Late complications of brucella infection

Diagnosis: Blood culture, marrow culture, liver biopsy and culture. Detection of raised Brucella agglutinins

Treatment: Doxycycline plus an aminoglycoside for 4 weeks and then doxycycline plus rifampicin for a further 8 weeks.

Copyright: Rob Skelly 2006