PubMed · 15400521
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A G BOWER. 1950. Brucellosis.. https://pubmed.ncbi.nlm.nih.gov/15400521/
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BACKGROUND: Brucellosis is a multi-systemic zoonotic infection. The West Asia/Middle East region is an important global hotspot for brucellosis. This systematic review and meta-analysis aimed to aggregate and synthesize all the available evidence regarding the complications of brucellosis in West Asia/Middle East region. METHODS: PubMed, Embase, Scopus, Web of Science, Google Scholar, and Proquest were searched. Selection of studies, data extraction, and the risk of bias assessment were performed in duplicate. Data extraction was performed for 254 complications. Meta-analysis was performed using a random-effects model with Freeman-Tukey double arcsine transformation. Where applicable small-study effects was assessed using funnel plots and Egger's test. Separate by-country, by-age, and by-publication-decade subgroup analyses were performed if feasible. RESULTS: Out of 9518 results, 240 studies (260 references) were included. The majority of the included studies were conducted in Turkey (n = 177). The reported complications varied and different complication categorization systems were detected. The highest pooled estimate was observed for musculoskeletal involvement (50%, 95%CI: 39%-61%, I2 = 96.63%). The evidences is up-to-date until March 4, 2024. CONCLUSIONS: Some complications such as the complications of the eye were not reported in all the countries. Therefore, it's recommended to determine the relative frequency of those complications in regions without such reports. The pooled estimates of different complications of brucellosis were different. There's a need for the standardization of the reporting of the complications of brucellosis to achieve comparability between studies and across different regions.
The term aseptic meningitis encompasses all types of inflammations of the brain meninges other than that caused by pus producing organisms. It is usually a benign illness. Etiology of aseptic meningitis is very wide and includes many infections - both viral and non viral, drugs, malignancy and systemic illness. The most common cause is viral infection and enteroviruses - Coxsackie and ECHO viruses account for more than half of all cases. Clinical manifestations include headache, fever, malaise, photophobia and meningeal signs. Convulsions, neurological deficits and severe obtundation are rare except with certain non viral infectious meningitis. Diagnostic work up includes blood and cerebrospinal fluid (CSF) examination and serology for infectious meningitis. The polymerase chain reaction is a rapid and accurate method for detection of microbial DNA in CSF. Treatment is mainly supportive, except for the nonviral infectious etiology.
A retrospective postal survey was carried out among 1240 clinical microbiology laboratory workers in Spain. Overall, 75 (43 microbiologists and 32 technicians) had suffered from laboratory-acquired brucellosis (LAB). Considering the total number of replies (N=628), the rate of LAB was 11.9%. The risk of suffering from LAB was clearly related to the number of isolates of Brucella spp. per year. A major break in biosafety measures was recognized in 60 cases (80%). In nine cases, processing was considered to be secure, and in six cases, the source of infection was unknown. Diagnosis was based on serology in all cases. In 51 cases (68%), blood cultures confirmed diagnosis. A variety of regimens were used to treat the 75 LAB cases. The combination of tetracycline and streptomycin was the most commonly used regimen (in 35 patients), followed by the combination of tetracycline and rifampicin (in 19 cases). Only 10 patients (13.3%) suffered from complications. No differences in resolution were observed according to the antimicrobial regimen. Microbiological laboratory workers are still at risk of developing LAB. Improvements in safety seem to be the best means of