Brucellosis

Brucellosis is a rare bacterial infection that you get from infected animals. Most people get it after eating or drinking contaminated animal products. But you can also get it from direct contact with infected animals. The bacterium Brucella causes brucellosis (pronounced “broo-suh-LOH-sis”). It gets into your body through your:

• Mouth
• Eyes
• Nose
• Cuts or scrapes in your skin

It then travels into your lymph nodes or tissues, where it slowly multiplies. From there, it can infect almost any part of your body, causing inflammation and damage.

There are around 100 to 200 cases of brucellosis in the U.S. each year. It causes flu-like symptoms that may appear around a week to two months after exposure. Your symptoms may even come and go over a long time.

Other names for brucellosis include:

• Undulant fever
• Malta fever
• Mediterranean fever

What symptoms does brucellosis cause?

Symptoms may include:

• Fever
• Sweatiness, which may smell moldy
• Joint pain, especially in your lower back, hips and knees
• Tiredness
• Loss of appetite
• Upset stomach
• Abdominal pain
• Unexplained weight loss
• Headache
• Swollen lymph nodes

Brucellosis causes

Several types of Brucella bacteria can cause brucellosis. These include:

• B. abortus
• B. canis
• B. meliensis
• B. suis

What animals are susceptible to Brucella?

The bacteria may affect many different types of animals. The animals that most commonly spread brucellosis to people include:

• Farm animals, like cows, bulls, pigs, sheep and goats
• Animals hunted for recreation, including deer, elk and moose
• Dogs, especially farm dogs and hunting dogs

How is it transmitted to humans?

The most common ways in which Brucella bacteria spread from infected animals to humans are through:

• Eating raw or undercooked meat
• Drinking or eating unpasteurized dairy products, including milk, cheese and butter
• Breathing in bacteria, usually from blood or exposed tissues
• Touching bodily fluids, including blood, pee, spit, semen or birthing fluids

It’s unlikely for brucellosis to pass from person to person. But in rare cases, it may spread:

• From a pregnant woman to a developing fetus
• Through breastfeeding

There have also been rare cases of brucellosis spreading through sexual intercourse. But it’s so rare that experts don’t consider it a sexually transmitted infection (STI).

Risk factors

Brucellosis exists in most countries around the world. But you’re at a higher risk of infection if you:

• Work as a veterinarian, rancher, butcher, dairy farmer or have another animal-related job
• Hunt and/or remove the organs of (dress) animals
• Eat raw or undercooked meat or unpasteurized dairy products
• Work in a microbiology laboratory

Complications

Some people develop long-term (chronic) brucellosis. It causes symptoms that come and go for years. You’re more likely to get it if you don’t get treatment. But it may develop even after treatment. Chronic brucellosis complications may include:

• An enlarged liver or spleen
• Abscesses in your spleen and liver (chronic hepatosplenic suppurative brucellosis)
• Arthritis in your joints, spine (spondylitis) and where your spine meets your pelvis (sacroiliitis)
• Involvement of the inside lining of your heart’s chambers and valves (endocarditis), brain or its covering (encephalitis or meningitis), bones (osteomyelitis), and testicles and the tube at the back of your testicles (epididymo-orchitis)
• Miscarriage

How is a Brucella infection diagnosed?

Healthcare providers will first review your health history, ask about your symptoms and perform a physical exam. Brucellosis can look like other diseases, so they may test for more common conditions to rule them out. During your appointment, they may ask questions like:

• Do you spend a lot of time around animals?
• Do you hunt?
• Do you eat meat?
• If you eat meat, how well do you cook it?
• Do you consume raw dairy products?

If they suspect you have a Brucella infection, they may suggest tests.

Tests that are used

The best way to confirm brucellosis is through a bacterial culture test. Your provider will take a blood sample and send it to a lab for testing. Lab techs will look for Brucella growth, which may take several weeks. You may need to do more than one blood test over a few weeks to check for signs.

Your provider may also recommend tests such as:

• Body fluid tests, including fluids from your spinal canal, joints or other parts of your body
• Tissue biopsy
• Imaging tests, including X-rays, CT scans, MRIs, bone scans or ultrasounds

Can brucellosis be cured?

Yes, healthcare providers can cure brucellosis with antibiotics. You’ll likely need a combination of at least two types of antibiotics. You must take them for at least six to eight weeks.

How is it treated?

Your provider will prescribe one or more of the following antibiotics:

• Streptomycin or gentamicin
• Rifampin
• Doxycycline
• Trimethoprim/sulfamethoxazole (TMP/SMX)
• Ciprofloxacin

You may be able to manage brucellosis symptoms like fever and joint pain with nonsteroidal anti-inflammatory drugs (NSAIDs). Not everyone can take NSAIDs. It’s a good idea to check with your provider first.

In some cases, you may need other treatments. This may include draining the infected areas or managing complications that develop.

Recovery time

It may take at least a few weeks to a few months to recover. It depends on how severe your Brucella infection is and when you start treatment. Your healthcare provider will give you a better idea of what to expect.

When should I see my healthcare provider?

Contact your healthcare provider if you have brucellosis symptoms, especially if you spend a lot of time around animals. Get to the nearest ER if you have new or worsening symptoms of a serious infection, including:

• A fever over 103 degrees Fahrenheit (39.4 degrees Celsius)
• Severe stomach pain
• Mental changes, including confusion

During your appointment, you may want to ask questions like:

• How will you diagnose brucellosis?
• If I don’t have brucellosis, what other disease might I have?
• How severe is my infection?
• What antibiotics do you recommend?
• How long do I have to take antibiotics?
• How should I store my medications?
• How can I manage my symptoms at home?
• Am I at risk for complications?
• Should I schedule follow-up appointments?

What can I expect if I have brucellosis?

With proper diagnosis and treatment, most people who get brucellosis make a full recovery. But it can take a long time. You’ll likely need to take antibiotics for several weeks or months until the bacteria in your body are gone. It’s important that you take your entire course of antibiotics. If you don’t, the infection can come back and be more difficult to treat.

Brucellosis can be deadly. But it’s rare. Fewer than 2 out of every 100 cases are fatal.

It’s possible to have complications that cause lasting damage. Some symptoms can last a long time, even after you finish treatment. This includes arthritis. You may need more treatments or therapies if you have complications.

Can brucellosis be prevented?

Practicing food safety and wearing protective clothing around animals are the best ways to prevent it. This includes:

• Not consuming unpasteurized milk
• Washing your hands, surfaces and any utensils you use to prepare meat
• Cooking meat to safe temperatures
• Wearing gloves, goggles and an apron when working with animals or handling animal tissues