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Clinical manifestations, diagnosis, and treatment of brucellosis

Mile Bosilkovski, MD
Section Editors
Stephen B Calderwood, MD
Morven S Edwards, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Brucellosis is a zoonotic infection transmitted to humans by contact with fluids from infected animals (sheep, cattle, goats, pigs, or other animals) or derived food products such as unpasteurized milk and cheese. It is one of the most widespread zoonoses worldwide [1]. Brucellosis has high morbidity both for humans and animals; it is an important cause of economic loss and a public health problem in many developing countries [2].

The clinical manifestations, diagnosis, and treatment of brucellosis will be reviewed here. The microbiology and epidemiology of the organism are discussed separately. (See "Microbiology, epidemiology, and pathogenesis of Brucella".)


The incubation period is usually one to four weeks; occasionally, it may be as long as several months [3,4]. It is generally accepted that Brucella melitensis causes more severe infection than Brucella abortus [5,6]. Brucella suis in humans can be as severe as B. melitensis [7]. However, in a small series, patients infected with B. suis did not have a more severe clinical course compared with those infected with B. abortus [8]. Brucella canis is infrequently associated with human disease, and reported cases have usually been mild [7].

Brucellosis is a systemic infection with a broad clinical spectrum, ranging from asymptomatic disease to severe and/or fatal illness [2]. Clinical and laboratory features vary widely (table 1 and table 2) [9]. The main presentations are acute febrile illness, with or without signs of localization, and chronic infection. Infection among children is generally more benign than in adults with respect to likelihood and severity of complications and response to treatment [10].

Brucellosis in pregnancy is associated with risk of spontaneous abortion, premature delivery, miscarriage, and intrauterine infection with fetal death [11-13].


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