tetracycline and Brucellosis

Brucellosis is a zoonotic disease that can be transmitted from animals to humans. Brucellosis is caused by bacteria of the genus Brucella, which are typically transmitted through contact with infected animals, unpasteurized dairy products, or airborne pathogens. Tetracyclines (tetracycline and doxycycline) are antibiotics commonly used to treat brucellosis; however, antibiotic resistance has become a major concern. This study assessed the worldwide prevalence of tetracycline-resistant Brucella isolates.. A systematic search was conducted in Scopus, PubMed, Web of Science, and EMBASE using relevant keywords and Medical Subject Headings (MeSH) terms until August 13, 2022, to identify relevant studies for meta-analysis. A random effects model was used to estimate the proportion of resistance. Meta-regression analysis, subgroup analysis, and examination of outliers and influential studies were also performed.. The prevalence rates of resistance to tetracycline and doxycycline were estimated to be 0.017 (95% confidence interval [CI], 0.009-0.035) and 0.017 (95%CI, 0.011-0.026), respectively, based on 51 studies conducted from 1983 to 2020. Both drugs showed increasing resistance over time (tetracycline: r = 0.077, P = 0.012; doxycycline: r = 0.059, P = 0.026).. The prevalence of tetracycline and doxycycline resistance in Brucella was low (1.7%) but increased over time. This increase in tetracycline and doxycycline resistance highlights the need for further research to understand resistance mechanisms and develop more effective treatments.

Topics: Animals; Anti-Bacterial Agents; Brucella abortus; Brucella melitensis; Brucellosis; Doxycycline; Humans; Prevalence; Tetracycline; Tetracyclines

To determine and quantify differences in efficacy between treatment regimens for brucellosis.. Systematic review and meta-analysis of randomised controlled trials assessing different antibiotic regimens and durations of treatment for human brucellosis.. PubMed, CENTRAL, Lilacs, conference proceedings, and bibliographies with no restrictions on language, study year, or publication status. Review methods Search, application of inclusion and exclusion criteria, data extraction, and assessment of methodological quality independently performed in duplicate. Primary outcomes were relapse and overall failure resulting from primary failure or relapse. Relative risks with 95% confidence intervals were calculated and pooled with a fixed effect model.. 30 trials and 77 treatment arms were included. Overall failure was significantly higher with doxycycline-rifampicin compared to doxycycline-streptomycin, mainly due to a higher rate of relapse (relative risk 2.80, 95% confidence interval 1.81 to 4.36; 13 trials, without heterogeneity). Results were consistent among patients with bacteraemia and complicated brucellosis. Doxycycline-streptomycin resulted in a significantly higher rate of failure than doxycycline-rifampicin-aminoglycoside (triple drug regimen) (2.50, 1.26 to 5.00; two trials). Gentamicin was not inferior to streptomycin (1.45, 0.52 to 4.00 for failure; two trials). Quinolones combined with rifampicin were significantly less effective than doxycycline combined with rifampicin or streptomycin (1.83, 1.11 to 3.02, for failure; five trials). Monotherapy was associated with a higher risk of failure than combined treatment when administered for a similar duration (2.56, 1.55 to 4.23; five trials). Treatment for six weeks or more offered an advantage over shorter treatment durations.. There are significant differences in effectiveness between currently recommended treatment regimens for brucellosis. The preferred treatment should be with dual or triple regimens including an aminoglycoside.

Topics: Aminoglycosides; Anti-Bacterial Agents; Brucellosis; Doxycycline; Drug Administration Schedule; Drug Therapy, Combination; Humans; Quinolones; Randomized Controlled Trials as Topic; Rifampin; Streptomycin; Tetracycline

The global burden of human brucellosis remains enormous, yet its optimal treatment remains based on traditional combinations of doxycycline with either rifampicin or streptomycin. Of the currently existing alternative regimens, only the combination of doxycycline with gentamicin can be considered therapeutically adequate and cost effective, the latter factor being a major obstacle in the utilisation of quinolones for brucellosis. Newer antibiotics, most notably tigecycline, may help in achieving monotherapy or shorter treatment duration. Alternatively, modification of the acidic intracellular environment where Brucellae reside may allow for enhanced effectiveness of existing antibiotics.

Topics: Anti-Bacterial Agents; Brucellosis; Drug Therapy, Combination; Humans; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

To review the clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis reporting to a tertiary care hospital in Riyadh, and to compare these with other cases reported previously.. In this retrospective study, records of all 26 adult patients with brucellosis, who presented with epididymitis or epididymo-orchitis at a tertiary hospital in Riyadh from 1983 to 2000, were reviewed. Positive blood culture or high agglutination titres of > or = 1 : 320 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. Among these cases, epididymitis or epididymo-orchitis was diagnosed on the basis of a typical history of gradual onset of scrotal pain and findings of enlarged tender testes and/or epididymis.. Epididymo-orchitis occurred in 1.6% of all patients with brucellosis. Most (58%) were 25--44 years old; approximately 77% of the patients presented with acute symptoms of < 2 weeks' duration. All patients complained of swollen painful testicles. Other presenting symptoms included undulant fever (96%), chills (54%) and arthralgia (23%). Four patients had dysuria and one haematuria. Ten patients gave a positive history of ingestion of raw milk and milk products; one patient had laboratory-acquired brucellosis. Six patients had unilateral epididymo-orchitis (two with features of florid presentation); the remaining 20 had only orchitis (bilateral in two, right in 10 and left in eight). Leucocytosis was present in six patients; 25 had initial agglutination titres of > 1 : 320 and the remaining patient had a positive blood culture. All patients received combined therapy with streptomycin for the first 2 weeks (or oral rifampicin for 6 weeks) with doxycycline or tetracycline for 6 weeks. All showed improvement, fever subsided in 2--5 days and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year.. In brucellosis-endemic areas, clinicians encountering epididymo-orchitis should consider the likelihood of brucellosis. A careful history, a meticulous physical examination and a rapid laboratory evaluation help in diagnosis. Clinical and serological data are sufficient for diagnosis. Leucocytosis is not an atypical feature of brucellar epididymo-orchitis and so cannot be used for differentiating it from the nonspecific variety. Conservative management with combination antibiotic therapy is adequate for managing brucellar epididymo-orchitis.

Topics: Adolescent; Adult; Aged; Brucellosis; Doxycycline; Drug Therapy, Combination; Epididymitis; Fever; Humans; Length of Stay; Male; Middle Aged; Orchitis; Retrospective Studies; Rifampin; Saudi Arabia; Streptomycin; Tetracycline

To the best of our knowledge, no case of acute pancreatitis associated with brucellosis has been reported. This report details the occurrence of acute pancreatitis in which Brucella melitensis was cultured from blood. We discuss various diagnostic tests and the recommended therapy for brucellosis.

Topics: Acute Disease; Adult; Brucellosis; Drug Therapy, Combination; Humans; Male; Pancreatitis; Streptomycin; Tetracycline

Topics: Brucella; Brucellosis; Chronic Disease; Enzyme-Linked Immunosorbent Assay; Humans; Rifampin; Serologic Tests; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: Abattoirs; Abscess; Agglutination Tests; Animals; Body Weight; Brucella; Brucella abortus; Brucellosis; Cattle; Chloramphenicol; Epididymitis; Fever; Humans; Illinois; Iowa; Lymphatic Diseases; Male; Occupational Diseases; Pyridazines; Splenomegaly; Streptomycin; Sulfanilamides; Tetracycline

The present study was undertaken to evaluate efficacy, safety and patient acceptability of three antibiotic regimens for the treatment of acute brucellosis. Six different centres were involved: three in France, one in Greece and two in Spain. The regimens were: oral rifampicin 900 mg/day plus oral doxycycline 200 mg/day for 45 days (A), oral doxycycline 200 mg/day for 45 days plus im streptomycin 1 g/day for 21 days (regimen B) [corrected] and the WHO regimen (C) combining oral tetracycline 2 g/day for 21 days plus im streptomycin, 1 g/day, for 14 days. Regimens A and B were randomly allocated in all centres, while regimen C was allocated only in two centres. All patients were suffering from acute brucellosis clinically and biologically proven. 143 patients were allocated for treatment and analysed. Their mean age was 41 years (range 13-70), 49 were female and 94 male, and their mean weight was 64 kg (range 35-98). Among these patients, 14% had localized disease (nine orchitis, eight osteo-articular involvement and one pleural effusion), but there was no statistical difference between the three regimens in regard to this localized disease. Forty-five per cent of the patients had positive blood cultures. The cure rate with regimen A was 95%, 96% with regimen B and 59% with regimen C. Thus regimen A presented the same efficacy rate as regimen B, but regimen C cannot be regarded as the treatment of choice for acute brucellosis.

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Body Temperature; Brucellosis; Doxycycline; Drug Therapy, Combination; Female; Humans; Male; Rifampin; Streptomycin; Tetracycline

Topics: Brucellosis; Clinical Trials as Topic; Drug Combinations; Humans; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

In an attempt to compare the efficacy of rifampin-doxycycline with tetracycline-streptomycin for the treatment of human brucellosis, we administered both combinations for a 30-day period, similar to the period recommended by the World Health Organization in a prospective, randomized trial. Forty-six patients were included in the final study (36 men and 10 women); 41 had blood cultures positive for Brucella melitensis. The 28 patients in group A received tetracycline hydrochloride at doses of 0.5 g every 6 h or doxycycline at 100 mg every 12 h for 30 days plus 1 g of streptomycin a day for 21 days. The 18 patients in group B received rifampin at 15 mg/kg per day in a single morning dose plus 100 mg of doxycycline every 12 h for 30 days. For patients with focal disease from both groups, therapy was prolonged to 45 days. All patients underwent rigorous clinical and bacteriological long-term follow-up. There were no therapeutic failures in either group, and the defervescence period was similar for both groups (3.1 days for group A, 2.6 days for group B). Two patients (7.1%) from group A had relapses, as did seven (38.8%) from group B (P = 0.024), and blood cultures again became positive for B. melitensis in all of them. In both groups treatment was generally well tolerated. The results strongly suggest that the rifampin-doxycycline combination is a less efficacious mode of therapy for brucellosis to prevent relapses than is the classical tetracycline-streptomycin combination when both are administered for 30 days. A more prolonged period of administration of the rifampin-doxycycline combination may be required to obtain the same low relapse rate as that achieved with the classical tetracycline-streptomycin treatment.

Topics: Adolescent; Adult; Brucellosis; Doxycycline; Drug Therapy, Combination; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Recurrence; Rifampin; Streptomycin; Tetracycline

Topics: Agglutination Tests; Brucellosis; Clinical Trials as Topic; Doxycycline; Evaluation Studies as Topic; Humans; Tetracycline

Brucellosis is a chronic disease caused by Brucella species with a wide range of hosts, from marine mammals to terrestrial species, but with strict host preferences. With the zoonotic character, the prevalence of human brucellosis cases is a reflection of animal infections. This study aimed to identify 192 Brucella isolates obtained from various sources by Bruce-ladder PCR and to determine their antibiotic susceptibilities by gradient diffusion method (E-test). As a result of the PCR, all human isolates (n = 57) were identified as B. melitensis. While 58 (82.9%) of the cattle isolates were identified as B. abortus, 59 (90.8%) of the sheep isolates were identified as B. melitensis. In addition, 12 (17.1%) of the cattle isolates and 6 (9.2%) of the sheep isolates were determined as B. melitensis and B. abortus, respectively. The primary host change behavior of B. melitensis was 1.9 times higher than that of B. abortus. While gentamicin and ciprofloxacin susceptibilities of Brucella isolates were 100%, tetracycline, doxycycline, streptomycin, trimethoprim/sulfamethoxazole and rifampicin susceptibilities were 99%, 99%, 97.4%, 91.7% and 83.9%, respectively. The lowest sensitivity of the isolates was determined against to cefoperazone as 26%. A triple-drug resistance was detected in 1 B. abortus isolate that included simultaneous resistance to cefoperazone, rifampicin, and trimethoprim/sulfamethoxazole. The high susceptibility profiles we found against to antibiotics such as tetracycline, doxycycline gentamicin and ciprofloxacin, used widely in treatment, are encouraging. However, the change in the canonical Brucella species-primary host preference suggests the need to reconsider eradication program, including updating vaccine formulations.

Topics: Animals; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Cattle; Cefoperazone; Ciprofloxacin; Doxycycline; Gentamicins; Humans; Mammals; Microbial Sensitivity Tests; Rifampin; Sheep; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Kazakhstan belongs to countries with a high level of brucellosis among humans and farm animals. Although antibiotic therapy is the main way to treat acute brucellosis in humans there is still little information on a circulation of the antibiotic-resistant. Susceptibilities to tetracyclin, gentamycin, doxycyclin, streptomycin and rifampicin were investigated in 329 clinical isolates of. All isolates were susceptible to streptomycin, tetracycline and doxycycline. 97.3% of the Brucella isolates were susceptible to gentamycin, although only 37.4% of isolates were susceptible to rifampicin. 21.9% of isolates had intermediate resistance, and 26.4% of isolates were resistant to this antibacterial drug.. Isolates of

Topics: Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Doxycycline; Drug Resistance, Multiple, Bacterial; Gentamicins; Humans; Kazakhstan; Microbial Sensitivity Tests; Rifampin; Streptomycin; Tetracycline

Topics: Anti-Bacterial Agents; Brucella; Brucellosis; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pituitary Diseases; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Brucellosis is one of the most common zoonotic disease affecting humans and animals and is endemic in many parts of the world including the Gulf Cooperation Council region (GCC). The aim of this study was to identify the species and determine the antimicrobial susceptibility pattern of Brucella strains isolated from clinical specimens, from Qatar.. We evaluated 231 Brucella isolates. All isolates were identified as B. melitensis. All the isolates were susceptible to doxycycline, tetracycline, streptomycin, gentamicin, trimethoprim / sulfamethoxazole and ciprofloxacin except rifampicin, where 48 % of the strains showed elevated MICs (>1 mg/L). The rifampicin-resistance related hotspots within the rpoB gene were amplified and sequenced using PCR and no rpoB mutations were found in strains with rifampicin MICs of >2 mg/L.. This study identified B. melitensis as the etiological agent of brucellosis in Qatar. No resistant isolates were detected among conventionally used antimicrobial agents.

Topics: Anti-Bacterial Agents; Bacterial Proteins; Brucella melitensis; Brucellosis; Doxycycline; Drug Resistance, Bacterial; Gentamicins; Humans; In Vitro Techniques; Microbial Sensitivity Tests; Qatar; Rifampin; Tetracycline

Although liver involvement is frequently seen in brucellosis, acute hepatitis is a rare clinical entity. In its progress, haematological findings are non-specific and vary in respect to severity. In this paper, we present a case of brucellosis with acute hepatitis and bicytopenia without anaemia. A 19-year-old man presented with a 2-week history of fever, sweating, low back and leg pain, lassitude, loss appetite, nausea and vomiting. He gave a history of raw milk ingestion and animal contact. Physical examination showed signs of icteric skin and sclera, tenderness in the right hypochondriac region and hepatosplenomegaly. On admission to hospital, laboratory tests showed WBC 3500/mmc (polymorphs 63% and lymphocytes 33%), haemoglobin 13.8 g/dL, platelet 89000/mmc, erythrocyte sedimentation rate 19 mm/h, and C-reactive protein 21.7 mg/dL (N<0.8 mg/dL). Biochemical tests were as follows: AST 771 U/L, ALT 471 U/L, ALP 355 U/L, GGT 432 U/L, total bilirubin 2.61 mg/dL, direct bilirubin 1.45 mg/dL and albumin 3.7 g/dL. Viral hepatitis markers were found to be negative (HBsAg, anti-HBc total, anti-HBc IgM, anti-HAV IgM, and anti-HCV). Blood culture grew Brucella melitensis. Leukopenia and thrombocytopenia returned to normal levels at the 7th and 14th day of his admission, respectively. Liver function tests improved at the 28th day. Treatment of the brucellosis was performed with antibiotics (tetracycline 500 mg orally four times daily for 6 weeks and streptomycin 1 g IM once daily for 21 days). Finally, a case of brucellosis with acute hepatitis and bicytopenia was treated with a successful outcome. In conclusion, we suggest that due consideration be taken of bicytopenia/pancytopenia and acute hepatitis in brucellosis cases in Turkey, an endemic region.

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Drug Therapy, Combination; Hepatitis; Humans; Leukopenia; Male; Streptomycin; Tetracycline; Thrombocytopenia; Treatment Outcome; Turkey

The aim of this study was to assess in vitro antimicrobial susceptibility of Brucella melitensis isolates isolated from naturally infected sheep cases in an area where human brucellosis is endemic, focusing on rifampin (RIF), streptomycin (SM), ciprofloxacin (CPFX), trimethoprim/sulfamethoxazole (TMP/SMZ), gentamicin (GM) and tetracycline (TC) and on 11 other antimicrobials. The identification and typing of Brucella isolates were carried out using standard classification tests and polymerase chain reaction (PCR) methods. Antimicrobial susceptibility testing was carried out on Mueller-Hilton agar. The resistance to SM, CPFX and GM was determined at the rate of 7.3% and to RIF at the rate of 9.7%. The highest (46.3%) resistance was determined against TMP/SMZ. All strains were found to be sensitive to TC at the rate of 100.0%. In conclusion, ovine origin B. melitensis strains evaluated in this study were resistant to at least one antimicrobial (51.2%) that is commonly used in human clinical medicine against brucellosis.

Topics: Animals; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Ciprofloxacin; DNA Primers; Gentamicins; Humans; Microbial Sensitivity Tests; Polymerase Chain Reaction; Rifampin; Sheep; Sheep Diseases; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim; Turkey

Topics: Anti-Bacterial Agents; Brucellosis; China; Humans; Streptomycin; Tetracycline; Time Factors; Treatment Outcome

Brucella spp. replicate and survive in lympho-proliferative tissues and cells, thus effective treatment of brucellosis requires the combined and long term use of intracellularly active antibiotics. Elimination of the microorganism largely depends on the reactive oxygen and nitrogen intermediates released by activated macrophages. In this study we aimed to determine the in vitro activity of hydrogen peroxide (H2O2; reactive oxygen intermediate) and acidified sodium nitrite (ASN; reactive nitrogen intermediate) alone and in combination with rifampicin (RIF) and tetracycline (TET) against four clinical isolates of Brucella melitensis. Initially minimal inhibitory concentrations of RIF and TET were determined by microbroth dilution susceptibility test. The activity of 2 and 5 mM H2O2 and 3 and 6 mM ASN was tested against each isolate by direct colony count from the agar plates inoculated with bacterial suspensions treated with H2O2 or ASN. The last step in the assay was to determine the combined effectiveness of RIF and TET plus H2O2 and ASN. From each three rolls of assay apparatus samples were taken at 0., 1., 6. and 24. hours and inoculated on Brucella agar. The plates were incubated at 37 degrees C for 48 hours and colonies were counted. While RIF alone or in combination with H2O2 supressed the growth of bacteria even in the first hour, TET alone did not show any effect in 24 hours. However, in combination with reactive oxygen and nitrogen intermediates TET affected bacterial growth starting from six hours. In conclusion, further explanation of the interactions between antibiotics and the substances produced by the immune system of the host during the infections caused by intracellular pathogens, might have an important impact on the determination of the treatment protocols and the measures to prevent relapses.

Topics: Animals; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Drug Interactions; Humans; Hydrogen Peroxide; Oxidants; Reactive Nitrogen Species; Reactive Oxygen Species; Rifampin; Sodium Nitrite; Tetracycline

A 30-year-old-lady, (Case 1) was found to have brucella uveitis in her left eye. Serum agglutination (SAT) and SAT/Coombs titers were positive at 1:320 and 1:160, respectively. In Case 2, a 12-year-old-girl diagnosis of left brucellosis uveitis was made. Both SAT and SAT/Coombs titers were positive at 1:1280. This report confirms that Brucellae organisms as a cause of uveitis.

Topics: Adult; Agglutination Tests; Brucellosis; Child; Coombs Test; Doxycycline; Drug Therapy, Combination; Eye Infections, Bacterial; Female; Humans; Panuveitis; Prednisolone; Rifampin; Tetracycline; Uveitis, Posterior

Over six months, 129 consecutive brucellosis cases were diagnosed in females attending the outpatients' clinics the females in Al-Azhar and Ain Shams Universities Hospitals. Their ages ranged between 12-65 years old. 113 (87.6%) gave history of raw milk consumption, 13 (10%) gave history of home slaughtering of sheep, 2 (1.5%) gave history of animal contact, and one patient gave history of abortion, that partner had brucellosis. A total of 61.2% of patients gave serum agglutination test of 1: 640, who suffered acute or subacute infection. Titers of 1:320 (38.8%) were found in the majority of chronic cases. Causes of endemic parasitosis were excluded. Symptoms were fever (79.5%), headache (72.4%), generalized arthralgia (65.3%), sweating (65.3%), chills (63.8%), backache (34.6%), abdominal pain (27.5%), loss of appetite (25.5%), lassitude (17.2%), myalgia (14.2%), monoarthralgia (7.9%). Spinal involvement was in 15% patients, who had chronic brucellosis. 32/35 were successfully treated with a combination of streptomycin and tetracycline, 17/21 with streptomycin and septrin, 38/43 with tetracycline and septrin, and 26/26 (100%) with rifampicin and tetracycline or septrin, which treated all resistant patients.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Anti-Bacterial Agents; Brucellosis; Child; Chronic Disease; Drug Therapy, Combination; Egypt; Female; Fever; Humans; Middle Aged; Rifampin; Risk Factors; Streptomycin; Tetracycline; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Brucellosis is a major zoonotic disease of global importance. Forty years after active drug therapy was defined, there is no optimum antibiotic therapy for brucellosis due to relatively high rates of relapse and treatment failure. The aim of this study was to assess the in vitro susceptibility of 60 Brucella melitensis isolates obtained from blood and fluids to tigecycline, tetracycline and three quinolones (ciprofloxacin, levofloxacin, moxifloxacin). The minimum inhibitory concentrations (MICs) of these antibiotics were determined by E-test method. According to the MIC90, levofloxacin (MIC90 0.094 microg/mL) was found to be the most active agent, followed by tigecycline (MIC90 0.125 microg/mL), moxifloxacin (MIC90 0.125 microg/mL), ciprofloxacin (MIC 90 0.19 microg/mL) and tetracycline (MIC90 0.25 microg/mL). The results suggest that tigecycline can be a therapeutic alternative option for the treatment of brucellosis.

Topics: Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Fluoroquinolones; Humans; In Vitro Techniques; Microbial Sensitivity Tests; Minocycline; Tetracycline; Tigecycline; Turkey

Topics: Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Ciprofloxacin; Drug Therapy, Combination; Humans; Microbial Sensitivity Tests; Mutation; Rifampin; Tetracycline

A 59-year-old male farmer presented with a rare case of spondylodiscitis as a manifestation of systemic brucellosis. The patient presented with radicular pain and restricted mobility of the spine due to localized muscle spasm in addition to systemic complaints. Magnetic resonance imaging demonstrated discovertebral involvement at the L4-5 intervertebral space, indicating infectious spondylodiscitis. The Rose-Bengal test was positive and the serum antibody titer was 1/1280. The patient was treated with streptomycin combined with tetracycline plus rifampicin, with complete recovery. Early diagnosis is important and prompt antibrucellar chemotherapy is effective in most cases. Therefore, spondylodiscitis due to brucellosis should be considered in the differential diagnosis of spinal infections.

Topics: Anti-Bacterial Agents; Brucellosis; Discitis; Drug Therapy, Combination; Humans; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Rifampin; Streptomycin; Tetracycline

Topics: Brucellosis; Ciprofloxacin; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Liver Abscess; Middle Aged; Rifampin; Severity of Illness Index; Tetracycline; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler

Brucella endocarditis is an underdiagnosed complication of human brucellosis, associated with high morbidity and mortality. We report the successful management of a number of cases of Brucella mellitensis endocarditis.. Seven consecutive cases of Brucella mellitensis endocarditis were treated over the last 20 years, based on high suspicion of the disease at first place. The early suspicion of Brucella endocarditis relied on medical history and a standard tube agglutination titer > or =20. Blood and/or cardiac tissue cultures were positive in all patients, but available late following surgery. All patients were successfully treated with a combination of aggressive medical and early surgical therapy. All affected valves were replaced within 1 week from admission (five aortic and three mitrals). Medical treatment included co-trimoxazole, tetracyclines and streptomycin, before surgery, followed by co-trimoxazole and tetracyclines for a median of 12 months (range: 3-15 months) after surgery until the titers returned to a level < or =1:160.. There were neither operative deaths nor recurrence of infection. One patient died two years after the operation due to massive cerebrovascular accident. Ten-year survival was 85.7+/-13.2%.. Although Brucella mellitensis endocarditis is a rare entity, its optimum management should be a combination of aggressive medical treatment and early surgical intervention, based on high degree of suspicion in areas with high incidence of the disease.

Topics: Adult; Aged; Brucella melitensis; Brucellosis; Combined Modality Therapy; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Humans; Male; Middle Aged; Streptomycin; Survival Rate; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

A 22-year-old man with leukocytoclastic vasculitis as a cutaneous manifestation of brucellosis is presented. Skin lesions resolved 48 hours after starting treatment with tetracycline and rifampicin. Although skin manifestations are rarely associated with infection due to Brucella and do not seem to worsen the prognosis, they may cause the patient to seek medical attention as well as contribute to the diagnosis.

Topics: Adult; Anti-Bacterial Agents; Antibiotics, Antitubercular; Biopsy; Brucella melitensis; Brucellosis; Humans; Male; Rifampin; Skin; Tetracycline; Vasculitis, Leukocytoclastic, Cutaneous

The aim of this study was to determine the rates, types, clinical features and treatment of osteoarthricular involvement of brucellosis in Turkey. In a restrospective study in adults, we investigated 238 patients diagnosed with brucellosis over a period of 6 years. A diagnosis of brucellosis was established by isolation of Brucella species in blood or by a compatible clinical picture together with a standard tube agglutination titre of > or = 1/160 of antibodies for brucellosis and/or demonstration of an at least four-fold rise in antibody titre in serum specimens taken over 2 or 3 weeks. Osteoarthricular involvement was defined by inflammatory signs in peripheral joints or by unrelieved pain at rest together with radiological alterations and/or radionuclide uptake in any deep joint. Eighty-seven patients (36.5%) had osteoarthricular involvement (58.6% female, 41.4% male), 47 (54.1%) of whom were reported to consume unpasteurised dairy products. The mean age was 32.3 +/- 16 years. Sacroiliitis was the most common involvement (n = 53, 60.9%) followed by peripheral arthritis (n = 17, 19.5%), spondylitis (n = 12, 13.8%) and bursitis (n = 5, 5.7%). During the observation period, 60 (69%) patients with osteoarthricular involvement and radiographic abnormalities. A bone scan was positive in 15 patients with no radiographic abnormalities. All patients received merely medical treatment and relapse occurred in five (5.7%) patients. Sacroiliitis has been determined as the most frequently observed type of osteoarthricular involvement in brucellosis in Turkey.

Topics: Adolescent; Adult; Age Distribution; Aged; Brucella; Brucellosis; Doxycycline; Female; Humans; Joint Diseases; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Ofloxacin; Retrospective Studies; Sacroiliac Joint; Technetium Tc 99m Exametazime; Tetracycline; Tomography, X-Ray Computed; Turkey

Seventy-three cases of acute brucellosis were studied in relation to fever duration and hospital stay following different drug combinations, including gentamicin plus cotrimoxazole, rifampicin plus doxycycline, rifampicin plus cotrimoxazole, rifampicin plus tetracycline, streptomycin plus doxycycline, doxycycline plus cotrimoxazole, tetracycline plus cotrimoxazole, and tetracycline plus streptomycin. No statistical significant difference was found between these combinations regarding early clinical response in human brucellosis.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Anti-Bacterial Agents; Antibiotics, Antitubercular; Brucella melitensis; Brucellosis; Child; Child, Preschool; Doxycycline; Female; Gentamicins; Humans; Infant; Male; Middle Aged; Retrospective Studies; Rifampin; Streptomycin; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Brucellosis is rare in pregnancy. Recently, an increase in the incidence of this disease has been observed in our area. We present 7 cases of brucellosis in pregnancy and review the literature on the effects of brucellosis on the outcome of pregnancy. Brucellosis is rare in the Middle East and Africa and the most common source of infection is unpasteurized milk products. Brucella is a coccobacillus, gram-negative bacterium, whose hosts are mostly animals. There is controversy about the relationship between brucellosis and the outcome of pregnancy. There is some evidence that there is a higher rate of complications such as abortion, premature rupture of membranes and preterm delivery in infected animals. Reasons for this difference in the impact of brucella in animals and man include the absence of the carbohydrate erythritol in the human placenta, which appears to be a preferential medium and growth factor for brucella in the placentas of animals. There is uncertainty regarding effects of brucella in early pregnancy and no evidence of its transplacental passage in later pregnancy, causing adverse obstetrical outcome, although recently there has been a single report of Brucella abortus (biotype 2). We present 7 cases of brucellosis in pregnant women found between 1977-1988. Its incidence among the women who delivered here is 0.007% (7/92, 768 deliveries). Our first case was complicated by preterm premature rupture of membranes and preterm delivery in the 20th week of gestation. In 2 other cases there was preterm delivery with 1 developing clinical chorioamnionitis. The 4 remaining women delivered at term, although 1 had preterm premature rupture of membranes and intra-uterine growth retardation, and 2 had postpartum endometritis.

Topics: Adult; Brucellosis; Drug Therapy, Combination; Female; Humans; Incidence; Infant, Newborn; Infant, Premature; Israel; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Rifampin; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Brucellosis is a classical zoonosis caused by a Gram-negative bacillus of the genus Brucella. Human brucellosis can either be acute or chronic and present with a variety of manifestations, mostly with fever and signs of musculo-skeletal involvement. It may be complicated by involvement of the cardiovascular, central nervous or genito-urinary systems. However, pulmonary brucellosis is a rare complication. We report a case of miliary and reticulo-nodular brucellar pneumonia with positive blood and sputum cultures and positive serological tests. To the best of our knowledge this is the first case to be reported from Israel of miliary pneumonia with sputum positive for brucellosis.

Topics: Adult; Brucellosis; Drug Therapy, Combination; Humans; Lung Diseases; Male; Radiography; Rifampin; Tetracycline

Topics: Adult; Brucella melitensis; Brucellosis; Coitus; Disease Transmission, Infectious; Female; Humans; Male; Streptomycin; Tetracycline

A 33-year-old patient from former Yugoslavia presented with low back pain and fever. Plain X-rays and myelography were normal, but a technetium-99m scan was suspect for vertebral osteomyelitis. Serology and blood cultures were positive for Brucella (melitensis). Antibiotic therapy with tetracycline and rifampicine rapidly improved the signs and symptoms of the infection. A retrospective analysis of 11 cases of Brucellosis treated in the Kantonsspital, Chur, over the years 1973 to 1992 revealed that 9 patients were foreign workers from rural areas in the Mediterranean region (Spain, Portugal, Italy, Yugoslavia, Greece). The majority had a history of consuming milk and dairy products from their own farm animals up to a few months before the onset of symptoms. Blood cultures were positive in 5 cases (B. melitensis) while the remaining 6 had high titers of agglutinating antibodies. A diagnostic delay of several weeks to months was typical. Because Brucellosis usually presents with unspecific often flu-like symptoms, with unspecific laboratory findings, and with a varying array of organ manifestations a high index of suspicion is essential for a timely diagnosis.

Topics: Adolescent; Adult; Brucella melitensis; Brucellosis; Diagnostic Imaging; Emigration and Immigration; Female; Humans; Male; Retrospective Studies; Rifampin; Rural Population; Spondylitis; Switzerland; Tetracycline

Topics: Adult; Animals; Ascitic Fluid; Brucella melitensis; Brucellosis; Denmark; Female; Goats; Humans; Hydrocephalus; Milk; Peritonitis; Rifampin; Tetracycline; Turkey; Ventriculoperitoneal Shunt; Yogurt

A 13-year-old girl sustained acute blindness of the left eye with bilateral papilledema. An extensive search for a cause revealed only acute Brucella infection, documented by blood cultures that were positive for Brucella and a rise and fall of Brucella agglutination titer. Computed tomographic scan of the orbit revealed thickening and irregularity of the optic nerve. The patient was treated with anti-Brucella therapy and high-dose corticosteroids, with resultant complete recovery and return of visual acuity, disappearance of papilledema, and return of the optic nerve to its normal shape and thickness.

Topics: Adolescent; Brucellosis; Female; Humans; Optic Neuritis; Prednisone; Saudi Arabia; Streptomycin; Tetracycline

Ciprofloxacin is a quinolone that penetrates well intracellularly. It was shown to be active against Brucella melitensis in vitro. In this study, ciprofloxacin and tetracycline were used to treat B. melitensis and B. abortus infections in mice. The drugs were given for 7, 14, 21 and 28 days. Tetracycline reduced spleen and liver weight and splenic bacterial counts and eliminated the infection in 70% of mice treated for 3 or 4 weeks. Ciprofloxacin, on the other hand, did not affect liver or spleen weight or bacterial counts after 3-4 weeks of therapy. It failed to eradicate the organism from any of the mice treated. It is concluded that ciprofloxacin is probably not suitable for the treatment of brucellosis.

Topics: Animals; Brucellosis; Ciprofloxacin; Drug Evaluation, Preclinical; Drug Therapy, Combination; Mice; Organ Size; Tetracycline; Time Factors

Experimental studies and clinical trials were performed on possible increase of antibiotic therapy efficacy in brucellosis patients by correction of the immunity disorders with vitamin A. It was experimentally shown that vitamin A increased cellular immunity and accelerated sanation of guinea pigs sensitized with Brucella abortus 19 BA. The clinical trials demonstrated that the use of vitamin A in a dose of 33,000 IU thrice a day for 10 to 12 days during the complex treatment of patients with acute (36 persons) and subacute (57 persons) brucellosis lowered the average period of manifestation of the disease clinical signs and formation of the antibodies, increased the skin allergic sensitivity, the lymphocyte blast cell transformation, the total number and subpopulations of the active T-cells, theophylline-resistant lymphocytes, phagocytic and metabolic activity of neutrophils, showed 1.5- and 2-fold increased in the frequency of the infection transformation into a chronic process in patients with acute or subacute brucellosis, respectively.

Topics: Adjuvants, Immunologic; Animals; Brucella abortus; Brucellosis; Drug Synergism; Drug Therapy, Combination; Female; Guinea Pigs; Humans; Immune Tolerance; Male; Streptomycin; Tetracycline; Vitamin A

A field study was conducted on Ossabaw Island, Georgia (USA) to determine the feasibility of delivering oral vaccines to wild swine (Sus scrofa). Baits were made of polymerbound fish meal and contained a gelatin capsule as a potential vaccine chamber. Two biomarkers, iophenoxic acid and tetracycline, were incorporated into each bait, and soured chicken mash was used as an attractant. Baits (n = 1,980) were distributed in a grid pattern on a 405-ha test site and monitored for animal disturbance. Within 72 hr, 88% of 393 monitored baits were gone, and observations of track-beds surrounding 100 baits indicated that at least 52% were taken by wild swine. Subsequent testing of 80 wild swine for the biomarkers revealed that 95% of the animals had consumed bait. Track-bed observations indicated that raccoons (Procyon lotor) were the only non-target animal that frequently took baits. Biomarker analyses indicated 44% of 16 raccoons tested had eaten bait. It was concluded that oral vaccine delivery to wild swine should be considered as a feasible method of control or eradication of pseudorabies and/or swine brucellosis in wild swine if effective vaccines become available.

Topics: Administration, Oral; Animals; Animals, Wild; Brucella Vaccine; Brucellosis; Herpesvirus 1, Suid; Iodine; Pseudorabies; Raccoons; Swine; Swine Diseases; Tetracycline; Vaccines; Viral Vaccines

During the year 1987, 106 cases of human brucellosis were studied prospectively at the Jordan University Hospital. The disease was more often diagnosed among adults (73.6%) than children (26.4%). Serious clinical complications were observed in 5.7% patients. An initial Brucella antibody titre greater than or equal to 160 proved to be reliable in confirming suspected cases of acute and subacute brucellosis. Culture of blood was found to be more sensitive (44.4%) and significant (P less than 0.02) than bone marrow culture (27.7%) for detecting Brucella melitensis. All patients treated with rifampicin plus tetracycline or co-trimoxazole were considered to be clinically cured by disappearance of all major clinical features of brucellosis. By contrast, 2/10 patients treated with rifampicin alone, as well as 1/56 patients treated with tetracycline and streptomycin, clinically relapsed. It is evident from this study that the treatment with rifampicin alone is not as effective in brucellosis as it is when given with another appropriate drug.

Topics: Adult; Brucellosis; Child; Child, Preschool; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Prospective Studies; Remission Induction; Rifampin; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

The clinical features of 21 episodes of skeletal brucellosis in 17 Iraqi patients are reported. Six had monarthritis of a large joint, six had spondylitis, and five had spondarthritis. Brucellosis remains a major health problem in Iraq. The disease is transmitted to man through the ingestion of unpasteurised milk or milk products but can also be acquired through physical contact.

Topics: Adult; Aged; Anti-Bacterial Agents; Arthritis, Infectious; Brucella abortus; Brucellosis; Drug Combinations; Drug Therapy, Combination; Female; Humans; Iraq; Male; Middle Aged; Spinal Diseases; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

A 9-year-old Inuit boy with brucellosis is presented. The most likely source of his infection was contaminated caribou meat. Brucella suis is enzootic in Canadian caribou herds and this case indicates that natives of the Arctic are a risk group for acquiring brucellosis through the ingestion of raw caribou meat.

Topics: Animals; Brucellosis; Canada; Child; Drug Therapy, Combination; Food Contamination; Gentamicins; Humans; Male; Meat; Reindeer; Tetracycline

Six cases of well-documented Brucella endocarditis are reported. All the patients gave a history of ingestion of raw milk and/or being in contact with sheep and/or camels during herding. The diagnosis was based in each case on a history of ingestion of raw milk, high titres of Brucella antibodies, a positive blood culture and echocardiography. A combination of tetracycline, rifampicin and streptomycin was found to be effective in eradicating the Brucella organism. Two cases required aortic valve replacement, and another two required replacement of both aortic and mitral valves. One case died before any surgical intervention could be performed and one patient did not require surgery. Although it was noted that the Brucella organism attacks mainly valves which are already damaged, it may also attack and infect normal valves.

Topics: Adolescent; Adult; Aortic Valve; Brucellosis; Endocarditis, Bacterial; Female; Humans; Male; Prognosis; Rifampin; Saudi Arabia; Tetracycline

Topics: Animals; Animals, Wild; Brucellosis; Brucellosis, Bovine; Cattle; Disease Reservoirs; Female; Humans; Male; Risk Factors; Streptomycin; Tetracycline

Changes in concentrations of IgM and IgG antibodies to Brucella were monitored for at least 13 mo by an enzyme-linked immunosorbent assay (ELISA) in 52 patients with culture-positive brucellosis. Two main patterns were observed. After an initial peak, 29 patients (56%) had a steady drop in their IgG levels, whereas 23 (44%) had more than one peak over time. All patients with a chronic form of brucellosis or a relapse were in the second group. In most cases, Brucella antibodies, although falling to low levels, remained measurable. Cutoff levels for IgM and IgG were calculated after considering serum antibody concentrations in people who had recovered from an infection. A separate normal range was established for occupationally exposed workers. On admission, sera from all patients contained Brucella antibody levels greater than established cutoff levels. Our results show that ELISA is an excellent method for diagnosis and follow-up of brucellosis.

Topics: Brucellosis; Drug Therapy, Combination; Enzyme-Linked Immunosorbent Assay; Follow-Up Studies; Humans; Immunoglobulin G; Immunoglobulin M; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim

A series of 40 patients presented with epididymo-orchitis between January 1983 and August 1985. In 14 brucellosis was diagnosed. In 10 of these (72%) both testis and epididymis were involved and 1 had bilateral disease. All patients with brucella epididymo-orchitis were treated with streptomycin and tetracycline and complete resolution occurred in 8 (57%).

Topics: Adolescent; Adult; Aged; Brucellosis; Epididymitis; Humans; Male; Middle Aged; Orchitis; Streptomycin; Tetracycline

Topics: Adult; Brucellosis; Drug Administration Schedule; Hawaii; Humans; Male; Streptomycin; Tetracycline

Five cases of Brucella infective endocarditis are described involving a native aortic valve, two native mitral valves, a mitral valve bioprosthesis, and a ventricular septal defect patch. The diagnosis of Brucella infective endocarditis was established from the clinical features, with a high Brucella serologic titer in each case. Blood and tissue cultures were positive in four of five patients. Two-dimensional echocardiograms demonstrated moderately large vegetations on the three affected native valves and the patch and also revealed the development of vegetation on the mitral bioprosthesis as the disease progressed. All the patients were successfully treated by combined surgical and medical therapy, the latter consisting of co-trimoxazole, tetracycline, and streptomycin/gentamicin for 6 weeks; the affected valves and the ventricular septal defect patch were all replaced. There were no operative deaths and there has been no recurrence of infection to date. One patient died suddenly of an unknown cause 1 year after the operation.

Topics: Adult; Aortic Valve; Brucellosis; Combined Modality Therapy; Drug Combinations; Echocardiography; Endocarditis, Bacterial; Female; Gentamicins; Heart Valve Prosthesis; Humans; Male; Mitral Valve; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Optimal treatment of prosthetic valve endocarditis due to Brucella melitensis is unknown. The presence of ring abscess makes extensive surgical débridement and valve replacement essential steps of management. Antimicrobial therapy with tetracycline hydrochloride plus streptomycin sulfate or sulfamethoxazole and trimethoprim can achieve the sterilization of infected cardiac tissue. Late bland periprosthetic leaks occur frequently. Reoperation can be safely performed after a period of antimicrobial therapy. Prolonged treatment with doxycycline hyclate seems advisable.

Topics: Adult; Aortic Valve; Brucella; Brucellosis; Drug Combinations; Drug Therapy, Combination; Endocarditis, Bacterial; Heart Valve Prosthesis; Humans; Male; Middle Aged; Reoperation; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim

We studied 50 children with brucellosis. Diagnoses were made from clinical pictures and agglutination titres. Fevers, sweating and chills were common complaints. Hepatosplenomegaly and arthritis were usual findings. Tetracycline is an effective drug for management of childhood brucellosis. Seven patients with relapse were treated successfully with combination of tetracycline and co-trimoxazole.

Topics: Adolescent; Age Factors; Agglutination Tests; Brucellosis; Child; Child, Preschool; Drug Combinations; Female; Humans; Iraq; Male; Pregnancy; Prospective Studies; Seasons; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

We have reported a case documenting the difficulties encountered in diagnosing and treating patients with brucellosis caused by Brucella canis, including the nonspecific clinical presentation, low level of intermittent bacteremias, the slow-growing, fastidious nature of the organism, and the lack of antigenic cross-reactivity with the antigens usually used in routine Brucella serology. Further, the predominant southeastern United States epidemiology of this organism and the importance of exposure to dogs are also demonstrated by this report. It is important that physicians caring for patients in this region of the country be aware of the epidemiologic, serologic, and microbiologic pitfalls encountered in diagnosing B canis infections.

Topics: Animals; Brucella; Brucellosis; Dog Diseases; Dogs; Fever of Unknown Origin; Humans; Male; Streptomycin; Tetracycline; Zoonoses

Topics: Animals; Brucellosis; Disease Reservoirs; Humans; Tetracycline

Topics: Adolescent; Adult; Aged; Brucellosis; Child; Chile; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Streptomycin; Tetracycline

The in vitro susceptibility of Brucella melitensis was examined vis-a-vis the clinical outcome in 75 patients with brucellosis. The initial MICs for Brucella isolates from patients who relapsed and from those who did not were similar. Furthermore, the MICs for isolates from patients whose infections relapsed were no different from those for original isolates. Our results clearly showed that neither initial nor subsequent antibiotic susceptibility plays a role in the likelihood of relapse of patients with brucellosis.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Brucella; Brucellosis; Child; Doxycycline; Drug Resistance, Microbial; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Prospective Studies; Recurrence; Rifampin; Streptomycin; Tetracycline

A 19-year-old man incurred a closed femoral fracture complicated by hematogenous dissemination of Brucella osteomyelitis. Repeated limited incision and drainage were ineffective in eradicating infection. Wide debridement, delayed wound closure, and vigorous antimicrobial therapy with streptomycin and tetracycline, along with cephalosporin for secondary staphylococcal infection, were necessary measures before the infection was eradicated. A constant awareness of brucella musculoskeletal infection is advisable when caring for patients frequently exposed to all kinds of livestock, including domesticated and wild animals.

Topics: Adult; Brucella abortus; Brucellosis; Cephalosporins; Combined Modality Therapy; Debridement; Drainage; Femoral Fractures; Fractures, Closed; Humans; Male; Osteomyelitis; Staphylococcal Infections; Streptomycin; Tetracycline; Time Factors; Wound Infection

Brucellosis, being eradicated among domestic animals in some countries, is still prevalent in some others where it poses a potential threat to the consumers of milk and cheese and those working with animals and meat. The patient presented below had contracted a severe and long-standing Brucella abortus infection by ingesting raw camel milk. She had signs of endocarditis and disseminated intravascular coagulation, but recovered when treated with tetracyclin and streptomycin.

Topics: Adult; Brucellosis; Disseminated Intravascular Coagulation; Endocarditis, Bacterial; Female; Humans; Streptomycin; Tetracycline

A 58-year-old woman with prolonged febrile illness was found to have brucellosis caused by Brucella canis, presumably acquired through contact with infected dogs. After initial laboratory tests failed to yield a diagnosis, the disease was confirmed by the Brucella agglutination test. A combination of tetracycline and streptomycin therapy was begun, and the illness resolved. B canis, a recently recognized cause of human brucellosis, must now be considered in patients with fever of unknown origin. With adequate medical therapy, rapid and complete recovery can be expected.

Topics: Animals; Brucellosis; Dogs; Drug Therapy, Combination; Female; Fever of Unknown Origin; Humans; Middle Aged; Streptomycin; Tetracycline; Zoonoses

Topics: Adolescent; Adult; Brucellosis; Denmark; Female; Humans; Streptomycin; Tetracycline; Travel

Topics: Adolescent; Adult; Brucellosis; Child; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: Bioprosthesis; Brucellosis; Endocarditis, Bacterial; Female; Heart Valve Prosthesis; Humans; Middle Aged; Streptomycin; Tetracycline

Topics: Adolescent; Adult; Aged; Brucellosis; Female; Humans; Male; Middle Aged; Retrospective Studies; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim

Bitches with naturally occurring Brucella canis infection were treated with combined antibiotic therapy consisting of tetracycline, dihydrostreptomycin, and trimethoprim-sulfadiazine. After treatment, all but 1 bitch became abacteremic, and serologic titers declined for a variable length of time (3 months to 1 years). Abortion did not occur while these bitches were abacteremic. Although sequential antibiotic therapy for 6 weeks did not eradicate Brucella canis from affected bitches, it did not prevent abortion. The number of live pups whelped and weaned by treated bitches was comparable with that in bitches before they became infected.

Topics: Abortion, Septic; Abortion, Veterinary; Animals; Brucellosis; Dihydrostreptomycin Sulfate; Dog Diseases; Dogs; Drug Combinations; Drug Therapy, Combination; Estrus; Female; Pregnancy; Pregnancy Complications, Infectious; Sepsis; Sulfadiazine; Tetracycline; Trimethoprim

IN vitro susceptibilities of 98 isolates of Brucella melitensis to N-formimidoyl thienamycin, tetracycline, co-trimoxazole, rifampin, and cefoxitin were determined. N-Formimidoyl thienamycin showed good activity which was similar to those of tetracycline and rifampin and different from that of the other beta-lactam antibiotic tested (cefoxitin), which showed poor activity. Co-trimoxazole showed good activity.

Topics: Anti-Bacterial Agents; Brucella; Brucellosis; Cefoxitin; Drug Combinations; Humans; Imipenem; Lactams; Microbial Sensitivity Tests; Rifampin; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

We would like to mention the difficulty in establishing a diagnosis of brucellosis without the help of the laboratory owing to the polymorphous of its symptomatology and its very variable evolution. Quoted are the different parameters used in the Development Laboratory "Dr. Ruiz Castañeda', such as the blue drop, fixation on surface, agglutination on plate, agglutination in tube, intradermal reaction and haemoculture, utilizing each of these in the moment it becomes positive, and its correlation with the state of suffering involved which permits us to catalogue the brucellosis as: acute, chronic and relapse brucellar. It determines also the significance that this classification has in the therapeutic management of the patient, and its evolution.

Topics: Antibodies, Bacterial; Brucellosis; Humans; Immunologic Techniques; Intradermal Tests; Oxytetracycline; Recurrence; Tetracycline

Topics: Adult; Brucella; Brucellosis; Femur; Humans; Male; Osteomyelitis; Radiography; Tetracycline

Topics: Adolescent; Adult; Aged; Animals; Brucellosis; Cats; Colorado Tick Fever; Dogs; Female; Humans; Leptospirosis; Male; Michigan; Middle Aged; Pasteurella Infections; Penicillins; Pregnancy; Psittacosis; Pyrimethamine; Relapsing Fever; Tetracycline; Toxoplasmosis; Zoonoses

A 16-year-old Mexican-American boy presented with acute brucella sacroileitis. The diagnosis was based on a significantly elevated agglutination titer and confirmed by the growth of B. melitensis after four weeks incubation in blood culture. The patient recovered completely after six weeks of Tetracycline therapy. Because Brucella infection responds to treatment well, this infection is important in the differential diagnosis of arthritis, especially in an area endemic for Brucella. The readily available serologic techniques should be used to support the diagnosis, while recognizing that because of the slow growth rate of B. melitensis, the appropriate laboratory procedure is essential.

Topics: Adolescent; Arthritis, Infectious; Brucellosis; Humans; Male; Radiography; Sacroiliac Joint; Tetracycline

Three cases of probable neurobrucellosis are reported. The diagnosis was made on the basis of immunological tests. Two patients with a clinical picture of meningomyelitis showed a definitive clinical improvement under tetracycline and streptomycin therapy. The immunological reactions found in the record case were even more positive in the spinal fluid than in the blood. In the case 3 with a clinical presentation of cerebral hemorrhage the histopathological studies demonstrated non specific chronic leptomeningitis and local hemorrhages in the caudate nucleus bilaterally. The diagnose and treatment of neurobrucellosis are discussed, stressing the importance of an early therapy.

Topics: Adolescent; Adult; Brucella; Brucellosis; Cerebral Hemorrhage; Female; Humans; Male; Meningitis; Myelitis; Peripheral Nervous System Diseases; Serologic Tests; Tetracycline

Topics: Acute Disease; Adolescent; Adult; Aged; Anti-Bacterial Agents; Brucella abortus; Brucellosis; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Male; Middle Aged; Streptomycin; Tetracycline

An 11-year-old girl developed a subacute illness characterized by fever, malaise, depression, and meningoencephalitis. The etiology remained elusive until her agglutinin titer against Brucella abortus rose from 1:20 to 1:320. Brucellosis is an uncommon illness in children, an neurological involvement has been described in only ten cases. Brucella meningoencephalitis is characterized by a lymphocytic pleocytosis and elevated protein in the cerebrospinal fluid. Patients respond well to specific therapy; it is important, therefore, to consider the diagnosis of brucellosis in patients with subacute meningitis of unexplained etiology.

Topics: Antibodies, Bacterial; Brucella abortus; Brucellosis; Child; Female; Humans; Meningoencephalitis; Tetracycline

Topics: Administration, Oral; Adolescent; Adult; Aged; Brucellosis; Humans; Injections, Intravenous; Middle Aged; Rolitetracycline; Tetracycline

The possibility of brucellosis should be considered in any case of obscure pyrexia, monoarthritis, fascitis or splenomegaly, especially in persons who have been in contact with cattle, pigs or goats, or who have recently visited the Mediterranean region or East Africa. Tetracycline controls the symptoms, and the addition of streptomycin reduces the tendency to relapse.

Topics: Abattoirs; Adult; Africa; Agglutination Tests; Animals; Australia; Brucella abortus; Brucellosis; Cattle; Child; Child, Preschool; Diagnosis, Differential; Female; Goats; Humans; Male; Pregnancy; Swine; Tetracycline

Slide agglutination and mercaptoethanol tube agglutination tests for canine brucellosis were performed on 158 dogs. Clinical status was compared with the serologic test results. Sera were from 56 clinically normal dogs, 63 dogs with reproductive disorders, and 39 dogs with various nonreproductive disorders that could be associated with canine brucellosis. Ten of 21 (48%) aborting bitches and 2 of 9 (22%) bitches with other reproductive disorders were seropositive for brucellosis. Enlarged testicles, orchitis, and epididymitis were the main clinical disorders associated with positive (33%) or suspect (20%) serologic reactions in 15 male dogs. In 13 dogs of both sexes, diskospondylitis and osteomyelitis were the most common nonreproductive disorders associated with seropositive status for canine brucellosis (46%). Of 138 stray dogs, 17 were seropositive for canine brucellosis. Treatment of seropositive animals with antibiotics gave variable results. Of the 296 serum samples tested, 43 (14.5%) gave a positive reaction by the slide agglutination test but were negative by the mercaptoethanol tube agglutination test. Correlation was not found between serologic results and sex or breed.

Topics: Abortion, Veterinary; Agglutination Tests; Animals; Brucellosis; Dog Diseases; Dogs; Female; Infertility; Male; Minocycline; Pregnancy; Tetracycline

Topics: Acute Disease; Adolescent; Adult; Brucellosis; Endocarditis, Bacterial; Female; Fever of Unknown Origin; Humans; Lung Diseases; Male; Middle Aged; Spinal Diseases; Streptomycin; Tetracycline

Acute cholecystitis is a rare complication of systemic brucellosis. This report details the occurrence of acute noncalculous cholecystitis in which Brucella suis was cultured from both the blood and the gallbladder. A discussion of the various diagnostic tests and the recommended therapy for brucellosis is included.

Topics: Acute Disease; Adult; Brucella; Brucellosis; Cholecystitis; Gallbladder; Humans; Male; Tetracycline

Topics: Arthritis, Infectious; Brucellosis; Humans; Tetracycline

Topics: Brucellosis; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Tetracycline

Brucella endocarditis is a rare, but often fatal, complication of brucellosis. A 32 year old man acquired brucellosis while on a visit to his former home in Greece and presented six months later with malaise, fever and aortic regurgitation. Blood cultures grew Brucella melitensis biotype 1. Combined chemotherapy with streptomycin, tetracycline and rifampin sterilized his blood; however, his aortic valve was replaced owing to recurrent emboli and cardiac failure. Over the next 18 months the patient's antibody titer to Brucella fell and his blood reamined sterile. Cure was achieved by resection of the infected aortic valve and 10 weeks of bactericidal therapy for B. melitensis.

Topics: Adult; Aortic Valve Insufficiency; Brucellosis; Drug Therapy, Combination; Endocarditis, Bacterial; Heart Valve Prosthesis; Humans; Male; Rifampin; Streptomycin; Tetracycline

The intracellular and bactericidal activity of rifampicine was observed in the treatment of experimental brucellosis in the mouse and guinea pig. Batches of mice infected by intraperitoneal route with B. melitensis, strain 53 H 38, were treated with rifampicine (20 mg/kg/day) or with tetracycline-base (200 mg/kg/day). When the treatment begins 14 days after inoculation and lasts a week, the rifampicine produces a more significant decrease of the weight of the spleen than does tetracycline. After 14 days' treatment, apart from this effect, the degree of infection of the spleen decreases at least 10(5) times with rifampicine and 10(2) times with tetracycline. After 21 days, bacteriological sterilization is obtained with rifampicine whereas 66% of the tetracycline-treated mice are still infected. However, a residual infection of weak intensity persists in 6.6% of the rifampicine-treated mice against 75% of the tetracycline-treated mice, as shown by an injection of Corynebacterium parvum and a cortisone treatment at the end of the antibiotherapy. If the antibiotic treatment begins on the day of inoculation, the greatly superior efficacity of rifampicine is in that case more rapid. Rifampicine (100 mg/kg/day) offers comparable efficacity in the guinea pig infected by intraperitoneal route with B. abortus strain 544; these efficacity is shown by the decrease in the weight of the spleen and the intensity of splenic and ganglionic infection. The rapid decrease of agglutinins and amboceptors after 7 days of treatment suggests the possible role of a suppressor of this antibiotic. Finally, the effect of rifampicine on the growth of the guinea pig was noted.

Topics: Animals; Brucella abortus; Brucellosis; Female; Guinea Pigs; Mice; Rifampin; Spleen; Tetracycline

Topics: Adult; Asthenia; Brucella abortus; Brucellosis; Depression; Fever; Humans; Male; Mental Disorders; Serologic Tests; Tetracycline

Topics: Acute Disease; Anti-Bacterial Agents; Brucellosis; Chronic Disease; Doxycycline; Drug Combinations; Gentamicins; Humans; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim

The serology, epidemiologic features and clinical presentation of 39 patients suffering from Brucellosis in Kenya are described. The prevalent species was Brucella melitensis. There was a striking preference in the localisation of the infection for the spine and the hip joint. The disease runs a protracted course. Phenomena due to hypersensitivity and neuropsychiatric disorders are discussed. Advice regarding specific treatment is given.

Topics: Adult; Brucella; Brucellosis; Child; Doxycycline; Drug Therapy, Combination; Female; Humans; Joint Diseases; Kenya; Male; Serologic Tests; Spinal Diseases; Streptomycin; Sulfadiazine; Sulfamethoxazole; Tetracycline; Trimethoprim

A Brucella melitensis infection involved three persons. The infections were acquired by contact with a culture suspension that had been spilled during a laboratory exercise. One of the patients had only indirect contact with the spilled culture, probably contact with contaminated fomites. Another of the patients developed a clinical remission before treatment with antibiotics and relapsed after six months. This patient also had a positive bone marrow culture when blood cultures were negative. The type of antibody response persisting in the sera of convalescents was studied by treating the sera with mercaptoethanol and rabbit antihuman IgM sera. In the patient who relapsed, IgG antibody predominated, whereas IgM persisted for over two years in the patient without relapsing disease.

Topics: Adult; Agglutination Tests; Brucellosis; Disease Outbreaks; Humans; Illinois; Male; Streptomycin; Tetracycline

Topics: Brucellosis; Chronic Disease; Drug Therapy, Combination; Humans; Recurrence; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: Adult; Agglutination Tests; Agglutinins; Brucella; Brucellosis; Cephalothin; Female; Humans; Infant, Newborn; Kanamycin; Male; Pregnancy; Pregnancy Complications, Infectious; Tetracycline

Topics: Animals; Brucella; Brucellosis; Dog Diseases; Dogs; Intervertebral Disc; Lumbar Vertebrae; Male; Osteomyelitis; Radiography; Sacrum; Spondylitis; Tetracycline; Thoracic Vertebrae

Topics: Animals; Brucellosis; Brucellosis, Bovine; Cattle; Doxycycline; Humans; Male; Protective Clothing; Tetracycline; Zoonoses

Topics: Africa; Asia; Brucellosis; Chloramphenicol; Chloroquine; Fever; Humans; Leishmaniasis, Visceral; Liver Abscess, Amebic; Malaria; Metronidazole; Plasmodium falciparum; Tetracycline; Travel; Trypanosomiasis, African; Tuberculosis; Typhoid Fever; United Kingdom

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Autopsy; Biopsy; Blood; Bone Marrow; Brucella; Brucellosis; Dog Diseases; Dogs; Female; Lymph Nodes; Male; Streptomycin; Tetracycline

Topics: Brucellosis; Economics, Medical; Humans; Tetracycline

Topics: Arthritis, Infectious; Arthritis, Rheumatoid; Bacterial Infections; Brucella abortus; Brucellosis; Diagnosis, Differential; Granuloma; Humans; Mycobacterium tuberculosis; Synovial Membrane; Tetracycline; Tuberculosis, Osteoarticular

Topics: Ampicillin; Brucella abortus; Brucellosis; Carbenicillin; Drug Synergism; Gentamicins; Humans; Kanamycin; Microbial Sensitivity Tests; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: Adhesiveness; Blood Sedimentation; Brucella Vaccine; Brucellosis; Cell Nucleus; Centrifugation, Density Gradient; Enterobacteriaceae; Escherichia coli; Female; Golgi Apparatus; Humans; Hypersensitivity; Lysosomes; Macrophages; Microscopy, Electron; Monocytes; Phagocytosis; Remission, Spontaneous; Salmonella; Salmonella typhimurium; Skin Tests; Tetracycline

Topics: Brucellosis; Humans; Male; Middle Aged; Peptic Ulcer; Postoperative Complications; Tetracycline

Topics: Administration, Oral; Ampicillin; Animals; Antigens, Bacterial; Blood; Bone Marrow; Brucella; Brucellosis; Dog Diseases; Dogs; Female; Lymph Nodes; Male; Tetracycline

Topics: Animals; Bacteriological Techniques; Brucellosis; Culture Techniques; Female; Injections, Intraperitoneal; Mice; Organ Size; Rifampin; Spleen; Tetracycline; Time Factors

Topics: Ampicillin; Animals; Brucellosis; Cell Count; Complement Fixation Tests; Corynebacterium Infections; Disease Models, Animal; Drug Combinations; Drug Interactions; Evaluation Studies as Topic; Female; Hemagglutination Tests; Injections, Intraperitoneal; Mice; Organ Size; Propionibacterium acnes; Pyrimidines; Spleen; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: Anti-Bacterial Agents; Brucellosis; Drug Combinations; Humans; Streptomycin; Tetracycline

Topics: Agglutination Tests; Brucellosis; Humans; Hydrocortisone; Hypersensitivity; Occupational Diseases; Skin Tests; Sulfamethoxazole; Tetracycline; Trimethoprim; Veterinary Medicine

Topics: Age Factors; Animals; Brucellosis; Brucellosis, Bovine; Cattle; Dog Diseases; Dogs; Goats; Humans; Occupational Diseases; Sex Factors; Sheep; Sheep Diseases; Streptomycin; Swine; Swine Diseases; Tetracycline; United States

Topics: Animals; Bacteriophage Typing; Brucellosis; Dihydrostreptomycin Sulfate; Dog Diseases; Dogs; Sulfadimethoxine; Tetracycline; United States

Topics: Adult; Anti-Bacterial Agents; Ascorbic Acid; Brucellosis; Chronic Disease; Drug Hypersensitivity; Female; Humans; Immunotherapy; Male; Middle Aged; Muramidase; Oleandomycin; Phagocytosis; Physical Therapy Modalities; Pigments, Biological; Prodigiosin; Pyrroles; Serratia marcescens; Stimulation, Chemical; Tetracycline; Vitamins

Topics: Abortion, Veterinary; Agglutination Tests; Animals; Antibody Formation; Antigen-Antibody Reactions; Blood; Brucella; Brucellosis; Dog Diseases; Dogs; Female; Guinea Pigs; Haplorhini; Humans; Male; Mice; Pregnancy; Rabbits; Species Specificity; Streptomycin; Sulfonamides; Tetracycline; United States

Topics: Adult; Aneurysm, Infected; Animals; Antacids; Aortic Valve; Brucella; Brucellosis; Brucellosis, Bovine; Cattle; Chloramphenicol; Digitalis Glycosides; Endocarditis, Bacterial; Heart Valve Prosthesis; Humans; Male; Oral Manifestations; Postoperative Complications; Prednisone; Streptomycin; Tetracycline

Topics: Adult; Agglutination Tests; Brucellosis; Humans; Hypertension; Male; Streptomycin; Subarachnoid Hemorrhage; Sulfonamides; Tetracycline

Topics: Acute Disease; Adult; Aged; Brucellosis; Chronic Disease; Female; Humans; Male; Middle Aged; Osteomyelitis; Radiography; Staphylococcal Infections; Tetracycline; Typhoid Fever

Topics: Adult; Animals; Brucella; Brucellosis; Disease Outbreaks; Dog Diseases; Dogs; Female; Humans; Immunoglobulins; Inuit; Leukocytes; Lymphoid Tissue; Male; Middle Aged; Mononuclear Phagocyte System; Reindeer; Skin Tests; Species Specificity; Tetracycline; Zoonoses

Topics: Adolescent; Adult; Aged; Appendicitis; Brucellosis; Child; Child, Preschool; Chloramphenicol; Cholangitis; Escherichia coli Infections; Female; Gastroenteritis; Humans; Infant; Male; Meningitis; Middle Aged; Respiratory Tract Infections; Tetracycline; Typhoid Fever

An outbreak of seven cases of Brucella melitensis infection in London was traced to Italian pecorino cheese (cheese made from unpasteurized sheep's milk) which had been obtained from village markets in central Italy, brought back to England, and distributed to the affected persons.It is emphasized that pecorino cheese made from unpasteurized milk should not be eaten unless it is known to have been stored for at least 90 days, the period during which these cheeses have been shown to become free from viable brucella organisms.

Topics: Adolescent; Aged; Brucella; Brucellosis; Cheese; Child; Child, Preschool; Disease Outbreaks; Female; Food Microbiology; Humans; London; Male; Middle Aged; Streptomycin; Tetracycline

Topics: Brucellosis; Cartilage Diseases; Humans; Inflammation; Laryngeal Cartilages; Male; Middle Aged; Tetracycline

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Benzoxazoles; Brucellosis; Child; Cholangitis; Humans; Infections; Middle Aged; Respiratory Tract Infections; Tetracycline; Urinary Tract Infections

Topics: Adolescent; Adult; Aged; Brucellosis; Child; Child, Preschool; Cortisone; Disease Outbreaks; Female; Humans; Italy; Male; Middle Aged; Oleandomycin; Streptomycin; Tetracycline

Topics: Adult; Brucella abortus; Brucellosis; Humans; Male; Meningoencephalitis; Streptomycin; Tetracycline

Topics: Brucellosis; Humans; Streptomycin; Tetracycline

Topics: Animals; Brucellosis; Calcification, Physiologic; Cattle; Cattle Diseases; Host-Parasite Interactions; Humans; Liver Abscess; Liver Cirrhosis; Occupational Diseases; Pathology; Spleen; Splenectomy; Suppuration; Tetracycline; Zoonoses

Topics: Brucellosis; Humans; Immunotherapy, Active; Phenylbutazone; Protein Synthesis Inhibitors; Tetracycline; Tietze's Syndrome; Vitamin A; Vitamin K; Vitamins

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Antigen-Antibody Reactions; Brucellosis; Endotoxins; Epidemiology; Host-Parasite Interactions; Humans; Pathology; Streptomycin; Tetracycline

Topics: Abscess; Anti-Bacterial Agents; Brucellosis; Chlortetracycline; Humans; Physiology; Protein Synthesis Inhibitors; Radiography; Spondylitis; Streptomycin; Tetracycline

Topics: Adolescent; Anti-Bacterial Agents; Brucellosis; Child; Chloramphenicol; Chlortetracycline; Demeclocycline; Epidemiology; Humans; Immunotherapy, Active; Infant; Italy; Oleandomycin; Statistics as Topic; Streptomycin; Tetracycline

Topics: Anti-Bacterial Agents; Brucella Vaccine; Brucellosis; Drug Therapy; Humans; Oleandomycin; Prednisolone; Tetracycline

In Canada, about 100 sporadically occurring cases of brucellosis are reported yearly. Three patients were admitted to one Montreal hospital in the first seven months of 1963; all were employed in or around a packing plant. One had pain and electrocardiographic changes suggestive of Brucella myocarditis; he recovered promptly. Symptoms of neurasthenia and anxiety are common and were observed in two of these three cases. Two had positive blood cultures; the third showed conclusive agglutination to Br. abortus (1:10,240). In some patients with frequent previous exposures to infection the agglutination response may be equivocal and difficult to interpret. All three patients responded well to tetracycline; streptomycin and corticosteroids also have a role in the therapy of some cases. There may also be some place for combined antibiotic and vaccine therapy. The program of control of the disease in cattle in Canada is aimed at eradication by 1967.

Topics: Animals; Anti-Bacterial Agents; Antigen-Antibody Reactions; Aspartate Aminotransferases; Brucella; Brucella abortus; Brucellosis; Canada; Cattle; Demeclocycline; Drug Therapy; Electrocardiography; Epidemiology; Hospitals, Veterans; Humans; Male; Meat-Packing Industry; Myocarditis; Occupational Diseases; Pain; Streptomycin; Tetracycline; United States; Veterans; Zoonoses

Topics: Animals; Anti-Bacterial Agents; Brucella; Brucellosis; Immunity; Mice; Pharmacology; Protein Synthesis Inhibitors; Research; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Humans; Lymecycline; Lysine; Protein Synthesis Inhibitors; Tetracycline

Topics: Adrenocorticotropic Hormone; Audiometry; Brucellosis; Humans; Neuritis; Streptomycin; Tetracycline; Toxicology; Vertigo; Vestibular Function Tests; Vestibular Nerve; Vestibular Neuronitis

Topics: Animals; Anti-Bacterial Agents; Brucella abortus; Brucellosis; Hydrocortisone; Male; Occupational Diseases; Streptomycin; Tetanus Toxoid; Tetracycline; Vaccination; Veterinary Medicine

Topics: Anti-Bacterial Agents; Brucellosis; Codeine; Diagnosis; Food Contamination; Humans; Massage; Milk; Nursing; Public Health; Tetracycline; United Kingdom

Topics: Anti-Bacterial Agents; Bacillus; Biomedical Research; Brucellosis; Chloramphenicol; Chlortetracycline; Communicable Diseases; Cycloserine; Diphtheria; Dysentery; Dysentery, Bacillary; Erythromycin; Escherichia coli Infections; Humans; Influenza, Human; Liver Extracts; Methicillin; Penicillins; Pneumonia; Research; Staphylococcal Infections; Streptomycin; Syphilis; Tetracycline; Trachoma; Tuberculosis; USSR

Topics: Anti-Bacterial Agents; Brucellosis; Injections, Intramuscular; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Humans; Oleandomycin; Tetracycline

Topics: Anti-Bacterial Agents; Brucella; Brucellosis; Humans; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Oleandomycin; Streptomycin; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Humans; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Chloramphenicol; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Oleandomycin; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Chloramphenicol; Protein Synthesis Inhibitors; Psychotherapy, Multiple; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Coombs Test; Hemagglutination; Hemagglutination Tests; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Brucellosis; Dermatologic Agents; Humans; Oleandomycin; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Follow-Up Studies; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Brucellosis; Chloramphenicol; Prednisone; Steroids; Tetracycline; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Typhus, Epidemic Louse-Borne

Topics: Anti-Bacterial Agents; Brucellosis; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Erythema; Humans; Medical Records; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Fever; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Protein Synthesis Inhibitors; Tetracycline