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Brucellosis : ウィキペディア英語版
Brucellosis

Brucellosis, Bang's disease, Crimean fever, Gibraltar fever, Malta fever, Maltese fever, Mediterranean fever, rock fever, or undulant fever,〔("Brucellosis" in the American Heritage Dictionary )〕〔(Maltese Fever ) ''by wrongdiagnosis.com, last Update: 25 February 2009 (12:01)'', retrieved 2009-02-26〕 is a highly contagious zoönosis caused by ingestion of unpasteurized milk or undercooked meat from infected animals or close contact with their secretions.〔(【引用サイトリンク】title=Diagnosis and Management of Acute Brucellosis in Primary Care )
''Brucella'' species are small, Gram-negative, nonmotile, nonspore-forming, rod-shaped (coccobacilli) bacteria. They function as facultative intracellular parasites, causing chronic disease, which usually persists for life. Four species infect humans: ''B. melitensis'', ''B. abortus'', ''B. suis'', and ''B. canis''. ''B. melitensis'' is the most virulent and invasive species; it usually infects goats and occasionally sheep. ''B. abortus'' is less virulent and is primarily a disease of cattle. ''B. suis'' is of intermediate virulence and chiefly infects pigs. ''B. canis'' affects dogs. Symptoms include profuse sweating and joint and muscle pain. Brucellosis has been recognized in animals and humans since the 20th century.
==Signs and symptoms==

The symptoms are like those associated with many other febrile diseases, but with emphasis on muscular pain and sweating. The duration of the disease can vary from a few weeks to many months or even years.
In the first stage of the disease, septicaemia occurs and leads to the classic triad of undulant fevers, sweating (often with characteristic smell, likened to wet hay), and migratory arthralgia and myalgia (joint and muscle pain). Blood tests characteristically reveal leukopenia and anemia, show some elevation of AST and ALT, and demonstrate positive Bengal Rose and Huddleston reactions.
This complex is, at least in Portugal, Israel, and Jordan, known as Malta fever. During episodes of Malta fever, melitococcemia (presence of brucellae in blood) can usually be demonstrated by means of blood culture in tryptose medium or Albini medium. If untreated, the disease can give origin to focalizations or become chronic. The focalizations of brucellosis occur usually in bones and joints and spondylodiscitis of the lumbar spine accompanied by sacroiliitis is very characteristic of this disease. Orchitis is also common in men.
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.
The disease's sequelae are highly variable and may include granulomatous hepatitis, arthritis, spondylitis, anaemia, leukopenia, thrombocytopenia, meningitis, uveitis, optic neuritis, endocarditis, and various neurological disorders collectively known as neurobrucellosis.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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