Brucella spp
[Lancet Infect Dis 2007;7:775, MMWR 2008;57:603, European Heart J 2009;30:2369-2413.]
Clinical
B. melitensis and B. abortus most common.
- associated with exposure to cattle, sheep, pigs, goats, dogs & unpasteurized dairy products. Notify microbiology if suspect (Level 3 pathogen).
- Almost always requires valve surgery.
- Treatment success: antibody titre < 1:60.
Diagnosis
- Blood cultures
- Serology
- Culture, immunohistology and PCR of surgical material
| Therapy | Dose | Duration |
|---|---|---|
| Doxycycline | 100mg PO bid | ≥ 3 months |
| + | ||
| TMP/SMX | 1 DS tab PO bid | ≥ 3 months |
| + | ||
| Rifampin | 300mg PO bid | ≥ 3 months |
| +/- | ||
| Gentamicin | 7mg/kg IV daily | 2-4 weeks |