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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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  1. Bosilkovski M, Dimzova M, Grozdanovski K. Natural history of brucellosis in an endemic region in different time periods. Acta Clin Croat 2009; 48:41.
  2. Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75:195.
  3. Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol 2007; 25:188.
  4. Fiori PL, Mastrandrea S, Rappelli P, Cappuccinelli P. Brucella abortus infection acquired in microbiology laboratories. J Clin Microbiol 2000; 38:2005.
  5. Young EJ. An overview of human brucellosis. Clin Infect Dis 1995; 21:283.
  6. Troy SB, Rickman LS, Davis CE. Brucellosis in San Diego: epidemiology and species-related differences in acute clinical presentations. Medicine (Baltimore) 2005; 84:174.
  7. WHO/CDS/EPR/2006.7. Brucellosis in humans and animals Geneva: World Health Organization, 2006.
  8. Buchanan TM, Faber LC, Feldman RA. Brucellosis in the United States, 1960-1972. An abattoir-associated disease. Part I. Clinical features and therapy. Medicine (Baltimore) 1974; 53:403.
  9. Bosilkovski M, Krteva L, Dimzova M, et al. Human brucellosis in Macedonia - 10 years of clinical experience in endemic region. Croat Med J 2010; 51:327.
  10. Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005; 352:2325.
  11. Doganay M, Aygen B. Human brucellosis: An overview. Int J Infect Dis 2003; 7:173.
  12. Khan MY, Mah MW, Memish ZA. Brucellosis in pregnant women. Clin Infect Dis 2001; 32:1172.
  13. Gotuzzo E, Carillo C. Brucella. In: Infectious Diseases, 3rd Ed, Gorbach SL, Bartlett JG, Blacklow NR (Eds), Lippincott Williams & Wilkins, Philadelphia 2004. p.1717.
  14. Moreno S, Ariza J, Espinosa FJ, et al. Brucellosis in patients infected with the human immunodeficiency virus. Eur J Clin Microbiol Infect Dis 1998; 17:319.
  15. Young EJ. Brucellosis: current epidemiology, diagnosis, and management. Curr Clin Top Infect Dis 1995; 15:115.
  16. Gotuzzo E, Pappas G. Brucellosis. In: Tropical Infectious Diseases: Principles, Pathogens and Practice, 3rd ed, Guerrant RL, Walker DH, Weller PF (Eds), Saunders Elsevier, Philadelphia 2011. p.271.
  17. Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.
  18. Hasanjani Roushan MR, Mohrez M, Smailnejad Gangi SM, et al. Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran. Epidemiol Infect 2004; 132:1109.
  19. Bosilkovski M, Krteva L, Caparoska S, Dimzova M. Osteoarticular involvement in brucellosis: study of 196 cases in the Republic of Macedonia. Croat Med J 2004; 45:727.
  20. Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 2002; 132:98.
  21. Bosilkovski M, Kirova-Urosevic V, Cekovska Z, et al. Osteoarticular involvement in childhood brucellosis: experience with 133 cases in an endemic region. Pediatr Infect Dis J 2013; 32:815.
  22. Hashemi SH, Keramat F, Ranjbar M, et al. Osteoarticular complications of brucellosis in Hamedan, an endemic area in the west of Iran. Int J Infect Dis 2007; 11:496.
  23. Colmenero JD, Ruiz-Mesa JD, Plata A, et al. Clinical findings, therapeutic approach, and outcome of brucellar vertebral osteomyelitis. Clin Infect Dis 2008; 46:426.
  24. Mousa AM, Bahar RH, Araj GF, et al. Neurological complications of brucella spondylitis. Acta Neurol Scand 1990; 81:16.
  25. Solera J, Lozano E, Martínez-Alfaro E, et al. Brucellar spondylitis: review of 35 cases and literature survey. Clin Infect Dis 1999; 29:1440.
  26. Bosilkovski M, Krteva L, Dimzova M, Kondova I. Brucellosis in 418 patients from the Balkan Peninsula: exposure-related differences in clinical manifestations, laboratory test results, and therapy outcome. Int J Infect Dis 2007; 11:342.
  27. Pappas G, Bosilkovski M, Akritidis N, et al. Brucellosis and the respiratory system. Clin Infect Dis 2003; 37:e95.
  28. Mantur BG, Biradar MS, Bidri RC, et al. Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years' experience in an endemic area. J Med Microbiol 2006; 55:897.
  29. Erdem H, Inan A, Elaldi N, et al. Respiratory system involvement in brucellosis: the results of the Kardelen study. Chest 2014; 145:87.
  30. Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.
  31. Rolando I, Olarte L, Vilchez G, et al. Ocular manifestations associated with brucellosis: a 26-year experience in Peru. Clin Infect Dis 2008; 46:1338.
  32. Ariza J, Servitje O, Pallarés R, et al. Characteristic cutaneous lesions in patients with brucellosis. Arch Dermatol 1989; 125:380.
  33. Ariza J, Bosilkovski M, Cascio A, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med 2007; 4:e317.
  34. Ariza J, Corredoira J, Pallares R, et al. Characteristics of and risk factors for relapse of brucellosis in humans. Clin Infect Dis 1995; 20:1241.
  35. Roushan MR, Gangi SM, Ahmadi SA. Comparison of the efficacy of two months of treatment with co-trimoxazole plus doxycycline vs. co-trimoxazole plus rifampin in brucellosis. Swiss Med Wkly 2004; 134:564.
  36. Solera J, Martínez-Alfaro E, Espinosa A. Recognition and optimum treatment of brucellosis. Drugs 1997; 53:245.
  37. Solera J, Martínez-Alfaro E, Espinosa A, et al. Multivariate model for predicting relapse in human brucellosis. J Infect 1998; 36:85.
  38. SPINK WW. What is chronic brucellosis? Ann Intern Med 1951; 35:358.
  39. Al Dahouk S, Tomaso H, Nöckler K, et al. Laboratory-based diagnosis of brucellosis--a review of the literature. Part II: serological tests for brucellosis. Clin Lab 2003; 49:577.
  40. Bosilkovski M, Katerina S, Zaklina S, Ivan V. The role of Brucellacapt test for follow-up patients with brucellosis. Comp Immunol Microbiol Infect Dis 2010; 33:435.
  41. Mantecón Mde L, Gutiérrez MP, Zarzosa Mdel P, et al. Influence of brucellosis history on serological diagnosis and evolution of patients with acute brucellosis. J Infect 2008; 57:397.
  42. al-Eissa YA, Assuhaimi SA, al-Fawaz IM, et al. Pancytopenia in children with brucellosis: clinical manifestations and bone marrow findings. Acta Haematol 1993; 89:132.
  43. Karakukcu M, Patiroglu T, Ozdemir MA, et al. Pancytopenia, a rare hematologic manifestation of brucellosis in children. J Pediatr Hematol Oncol 2004; 26:803.
  44. al Deeb SM, Yaqub BA, Sharif HS, Phadke JG. Neurobrucellosis: clinical characteristics, diagnosis, and outcome. Neurology 1989; 39:498.
  45. Guven T, Ugurlu K, Ergonul O, et al. Neurobrucellosis: clinical and diagnostic features. Clin Infect Dis 2013; 56:1407.
  46. López-Cortés LF, Cruz-Ruiz M, Gómez-Mateos J, et al. Adenosine deaminase activity in the CSF of patients with aseptic meningitis: utility in the diagnosis of tuberculous meningitis or neurobrucellosis. Clin Infect Dis 1995; 20:525.
  47. Araj GF, Lulu AR, Mustafa MY, Khateeb MI. Evaluation of ELISA in the diagnosis of acute and chronic brucellosis in human beings. J Hyg (Lond) 1986; 97:457.
  48. Araj GF. Human brucellosis: a classical infectious disease with persistent diagnostic challenges. Clin Lab Sci 1999; 12:207.
  49. Mantur BG, Mangalgi SS. Evaluation of conventional castaneda and lysis centrifugation blood culture techniques for diagnosis of human brucellosis. J Clin Microbiol 2004; 42:4327.
  50. Kolman S, Maayan MC, Gotesman G, et al. Comparison of the Bactec and lysis concentration methods for recovery of Brucella species from clinical specimens. Eur J Clin Microbiol Infect Dis 1991; 10:647.
  51. Yagupsky P, Peled N, Press J, et al. Comparison of BACTEC 9240 Peds Plus medium and isolator 1.5 microbial tube for detection of Brucella melitensis from blood cultures. J Clin Microbiol 1997; 35:1382.
  52. Gotuzzo E, Carrillo C, Guerra J, Llosa L. An evaluation of diagnostic methods for brucellosis--the value of bone marrow culture. J Infect Dis 1986; 153:122.
  53. Gazapo E, Gonzalez Lahoz J, Subiza JL, et al. Changes in IgM and IgG antibody concentrations in brucellosis over time: importance for diagnosis and follow-up. J Infect Dis 1989; 159:219.
  54. Mert A, Ozaras R, Tabak F, et al. The sensitivity and specificity of Brucella agglutination tests. Diagn Microbiol Infect Dis 2003; 46:241.
  55. Godfroid J, Cloeckaert A, Liautard JP, et al. From the discovery of the Malta fever's agent to the discovery of a marine mammal reservoir, brucellosis has continuously been a re-emerging zoonosis. Vet Res 2005; 36:313.
  56. Young EJ. Serologic diagnosis of human brucellosis: analysis of 214 cases by agglutination tests and review of the literature. Rev Infect Dis 1991; 13:359.
  57. Serra J, Viñas M. Laboratory diagnosis of brucellosis in a rural endemic area in northeastern Spain. Int Microbiol 2004; 7:53.
  58. Memish ZA, Almuneef M, Mah MW, et al. Comparison of the Brucella Standard Agglutination Test with the ELISA IgG and IgM in patients with Brucella bacteremia. Diagn Microbiol Infect Dis 2002; 44:129.
  59. Baldi PC, Giambartolomei GH, Wallach JC, et al. Limited diagnostic usefulness of antibodies to cytoplasmic proteins of Brucella in early-treated human brucellosis. Scand J Infect Dis 2001; 33:200.
  60. Al Dahouk S, Nöckler K. Implications of laboratory diagnosis on brucellosis therapy. Expert Rev Anti Infect Ther 2011; 9:833.
  61. Rubach MP, Halliday JE, Cleaveland S, Crump JA. Brucellosis in low-income and middle-income countries. Curr Opin Infect Dis 2013; 26:404.
  62. Young EJ. Human brucellosis. Rev Infect Dis 1983; 5:821.
  63. Gad El-Rab MO, Kambal AM. Evaluation of a Brucella enzyme immunoassay test (ELISA) in comparison with bacteriological culture and agglutination. J Infect 1998; 36:197.
  64. ZINNEMAN HH, GLENCHUR H, HALL WH. The nature of blocking antibodies in human brucellosis. J Immunol 1959; 83:206.
  65. Wilkinson PC. Immunoglobulin patterns of antibodies against Brucella in man and animals. J Immunol 1966; 96:457.
  66. Morata P, Queipo-Ortuño MI, Reguera JM, et al. Development and evaluation of a PCR-enzyme-linked immunosorbent assay for diagnosis of human brucellosis. J Clin Microbiol 2003; 41:144.
  67. Lindquist D, Chu MC, Probert WWS. Francisella and Brucella. In: Manual of Clinical Microbiology, 9th Ed, Murray PR, Baron EJO, Jorgensen JH, Landry ML, Pfaller MA (Eds), ASM Press, Washington DC 2007. p.824.
  68. Gee JE, De BK, Levett PN, et al. Use of 16S rRNA gene sequencing for rapid confirmatory identification of Brucella isolates. J Clin Microbiol 2004; 42:3649.
  69. Marianelli C, Petrucca A, Pasquali P, et al. Use of MLVA-16 typing to trace the source of a laboratory-acquired Brucella infection. J Hosp Infect 2008; 68:274.
  70. Al Dahouk S, Flèche PL, Nöckler K, et al. Evaluation of Brucella MLVA typing for human brucellosis. J Microbiol Methods 2007; 69:137.
  71. Khateeb MI, Araj GF, Majeed SA, Lulu AR. Brucella arthritis: a study of 96 cases in Kuwait. Ann Rheum Dis 1990; 49:994.
  72. Sommers H M. The microbiology laboratory in the diagnosis of infectious arthritis. Clin Rhemn Dis 1978; 4:63.
  73. Goldenberg DL, Reed JI. Bacterial arthritis. N Engl J Med 1985; 312:764.
  74. Julkunen H. Reactive arthritis. Bull Rheum Dis 1979; 29:1002.
  75. Andonopoulos AP, Asimakopoulos G, Anastasiou E, Bassaris HP. Brucella arthritis. Scand J Rheumatol 1986; 15:377.
  76. Ariza J, Pigrau C, Cañas C, et al. Current understanding and management of chronic hepatosplenic suppurative brucellosis. Clin Infect Dis 2001; 32:1024.
  77. Pourbagher A, Pourbagher MA, Savas L, et al. Epidemiologic, clinical, and imaging findings in brucellosis patients with osteoarticular involvement. AJR Am J Roentgenol 2006; 187:873.
  78. Solera J. Treatment of human brucellosis. J Med Liban 2000; 48:255.
  79. Yousefi-Nooraie R, Mortaz-Hejri S, Mehrani M, Sadeghipour P. Antibiotics for treating human brucellosis. Cochrane Database Syst Rev 2012; 10:CD007179.
  80. Pappas G, Papadimitriou P, Christou L, Akritidis N. Future trends in human brucellosis treatment. Expert Opin Investig Drugs 2006; 15:1141.
  81. Joint Food and Agriculture Organization (FAO), World Health Organization (WHO). FAO-WHO expert committee on brucellosis (Sixth report). WHO technical report series, no 740. Geneva: World Health Organization; 1986: p. 56-7.
  82. Hasanjani Roushan MR, Mohraz M, Hajiahmadi M, et al. Efficacy of gentamicin plus doxycycline versus streptomycin plus doxycycline in the treatment of brucellosis in humans. Clin Infect Dis 2006; 42:1075.
  83. Ariza J, Gudiol F, Pallares R, et al. Treatment of human brucellosis with doxycycline plus rifampin or doxycycline plus streptomycin. A randomized, double-blind study. Ann Intern Med 1992; 117:25.
  84. Solera J, Rodríguez-Zapata M, Geijo P, et al. Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas. Antimicrob Agents Chemother 1995; 39:2061.
  85. Solera J, Martínez-Alfaro E, Sáez L. [Meta-analysis of the efficacy of the combination of +rifampicin and doxycycline in the treatment of human brucellosis]. Med Clin (Barc) 1994; 102:731.
  86. Skalsky K, Yahav D, Bishara J, et al. Treatment of human brucellosis: systematic review and meta-analysis of randomised controlled trials. BMJ 2008; 336:701.
  87. Al-Tawfiq JA. Therapeutic options for human brucellosis. Expert Rev Anti Infect Ther 2008; 6:109.
  88. Falagas ME, Bliziotis IA. Quinolones for treatment of human brucellosis: critical review of the evidence from microbiological and clinical studies. Antimicrob Agents Chemother 2006; 50:22.
  89. Akova M, Uzun O, Akalin HE, et al. Quinolones in treatment of human brucellosis: comparative trial of ofloxacin-rifampin versus doxycycline-rifampin. Antimicrob Agents Chemother 1993; 37:1831.
  90. Karabay O, Sencan I, Kayas D, Sahin I. Ofloxacin plus rifampicin versus doxycycline plus rifampicin in the treatment of brucellosis: a randomized clinical trial [ISRCTN11871179]. BMC Infect Dis 2004; 4:18.
  91. Mousa AR, Elhag KM, Khogali M, Marafie AA. The nature of human brucellosis in Kuwait: study of 379 cases. Rev Infect Dis 1988; 10:211.
  92. Ranjbar M, Keramat F, Mamani M, et al. Comparison between doxycycline-rifampin-amikacin and doxycycline-rifampin regimens in the treatment of brucellosis. Int J Infect Dis 2007; 11:152.
  93. El Miedany YM, El Gaafary M, Baddour M, Ahmed I. Human brucellosis: do we need to revise our therapeutic policy? J Rheumatol 2003; 30:2666.
  94. Mantur BG, Akki AS, Mangalgi SS, et al. Childhood brucellosis--a microbiological, epidemiological and clinical study. J Trop Pediatr 2004; 50:153.
  95. al-Eissa YA, Kambal AM, al-Nasser MN, et al. Childhood brucellosis: a study of 102 cases. Pediatr Infect Dis J 1990; 9:74.
  96. Alp E, Doganay M. Current therapeutic strategy in spinal brucellosis. Int J Infect Dis 2008; 12:573.
  97. Alp E, Koc RK, Durak AC, et al. Doxycycline plus streptomycin versus ciprofloxacin plus rifampicin in spinal brucellosis [ISRCTN31053647]. BMC Infect Dis 2006; 6:72.
  98. Pappas G, Seitaridis S, Akritidis N, Tsianos E. Treatment of brucella spondylitis: lessons from an impossible meta-analysis and initial report of efficacy of a fluoroquinolone-containing regimen. Int J Antimicrob Agents 2004; 24:502.
  99. Pappas G, Akritidis N, Christou L. Treatment of neurobrucellosis: what is known and what remains to be answered. Expert Rev Anti Infect Ther 2007; 5:983.
  100. Gul HC, Erdem H, Gorenek L, et al. Management of neurobrucellosis: an assessment of 11 cases. Intern Med 2008; 47:995.
  101. Erdem H, Ulu-Kilic A, Kilic S, et al. Efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the Istanbul study. Antimicrob Agents Chemother 2012; 56:1523.
  102. McLean DR, Russell N, Khan MY. Neurobrucellosis: clinical and therapeutic features. Clin Infect Dis 1992; 15:582.
  103. Lulu AR, Araj GF, Khateeb MI, et al. Human brucellosis in Kuwait: a prospective study of 400 cases. Q J Med 1988; 66:39.
  104. Mert A, Kocak F, Ozaras R, et al. The role of antibiotic treatment alone for the management of Brucella endocarditis in adults: a case report and literature review. Ann Thorac Cardiovasc Surg 2002; 8:381.
  105. Koruk ST, Erdem H, Koruk I, et al. Management of Brucella endocarditis: results of the Gulhane study. Int J Antimicrob Agents 2012; 40:145.
  106. Pellicer T, Ariza J, Foz A, et al. Specific antibodies detected during relapse of human brucellosis. J Infect Dis 1988; 157:918.
  107. Baldi PC, Miguel SE, Fossati CA, Wallach JC. Serological follow-up of human brucellosis by measuring IgG antibodies to lipopolysaccharide and cytoplasmic proteins of Brucella species. Clin Infect Dis 1996; 22:446.
  108. Payne DJ. Letter: Chronic brucellosis. Br Med J 1974; 2:221.
  109. Morata P, Queipo-Ortuño MI, Reguera JM, et al. Posttreatment follow-Up of brucellosis by PCR assay. J Clin Microbiol 1999; 37:4163.
  110. Goldbaum FA, Rubbi CP, Wallach JC, et al. Differentiation between active and inactive human brucellosis by measuring antiprotein humoral immune responses. J Clin Microbiol 1992; 30:604.
  111. Navarro E, Segura JC, Castaño MJ, Solera J. Use of real-time quantitative polymerase chain reaction to monitor the evolution of Brucella melitensis DNA load during therapy and post-therapy follow-up in patients with brucellosis. Clin Infect Dis 2006; 42:1266.
  112. Vrioni G, Pappas G, Priavali E, et al. An eternal microbe: Brucella DNA load persists for years after clinical cure. Clin Infect Dis 2008; 46:e131.
  113. Gulsun S, Aslan S, Satici O, Gul T. Brucellosis in pregnancy. Trop Doct 2011; 41:82.
  114. Montejo JM, Alberola I, Glez-Zarate P, et al. Open, randomized therapeutic trial of six antimicrobial regimens in the treatment of human brucellosis. Clin Infect Dis 1993; 16:671.
  115. Tanir G, Tufekci SB, Tuygun N. Presentation, complications, and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009; 51:114.
  116. El-Amin EO, George L, Kutty NK, et al. Brucellosis in children of Dhofar Region, Oman. Saudi Med J 2001; 22:610.
  117. Issa H, Jamal M. Brucellosis in children in south Jordan. East Mediterr Health J 1999; 5:895.
  118. Khuri-Bulos NA, Daoud AH, Azab SM. Treatment of childhood brucellosis: results of a prospective trial on 113 children. Pediatr Infect Dis J 1993; 12:377.
  119. Lubani MM, Dudin KI, Sharda DC, et al. A multicenter therapeutic study of 1100 children with brucellosis. Pediatr Infect Dis J 1989; 8:75.
  120. American Academy of Pediatrics. Brucellosis. In: Red Book: 2015 Report of the Committee on Infectious Diseases, 30th, Kimberlin DW, Brady MT, Jackson MA, Long SS (Eds), American Academy of Pediatrics, Elk Grove Village 2015. p.268.
  121. Roushan MR, Mohraz M, Janmohammadi N, Hajiahmadi M. Efficacy of cotrimoxazole and rifampin for 6 or 8 weeks of therapy in childhood brucellosis. Pediatr Infect Dis J 2006; 25:544.
  122. Gottesman G, Vanunu D, Maayan MC, et al. Childhood brucellosis in Israel. Pediatr Infect Dis J 1996; 15:610.
  123. Sánchez-Tamayo T, Colmenero JD, Martínez-Cortés F, et al. Failure of short-term antimicrobial therapy in childhood brucellosis. Pediatr Infect Dis J 1997; 16:323.
  124. Lubani MM, Dudin KI, Araj GF, et al. Neurobrucellosis in children. Pediatr Infect Dis J 1989; 8:79.
  125. Habeeb YK, Al-Najdi AK, Sadek SA, Al-Onaizi E. Paediatric neurobrucellosis: case report and literature review. J Infect 1998; 37:59.
  126. Omar FZ, Zuberi S, Minns RA. Neurobrucellosis in childhood: six new cases and a review of the literature. Dev Med Child Neurol 1997; 39:762.
  127. Centers for Disease Control and Prevention (CDC). Laboratory-acquired brucellosis--Indiana and Minnesota, 2006. MMWR Morb Mortal Wkly Rep 2008; 57:39.
  128. Wright SG. Brucellosis. In: Hunter’s Tropical Medicine and Emerging Infectious Diseases, 8th ed, Strickland GT (Ed), W.B. Saunders Company, Philadelphia 2000. p.416.
  129. Corbel MJ. Brucellosis: an overview. Emerg Infect Dis 1997; 3:213.
  130. Cassataro J, Pasquevich KA, Estein SM, et al. A DNA vaccine coding for the chimera BLSOmp31 induced a better degree of protection against B. ovis and a similar degree of protection against B. melitensis than Rev.1 vaccination. Vaccine 2007; 25:5958.
  131. Commander NJ, Spencer SA, Wren BW, MacMillan AP. The identification of two protective DNA vaccines from a panel of five plasmid constructs encoding Brucella melitensis 16M genes. Vaccine 2007; 25:43.