A23.1 Brucellosis due to Brucella abortus

Name of the Condition

• Brucellosis due to Brucella abortus

Summary

Brucellosis due to Brucella abortus is a bacterial infection caused by the Brucella abortus species, which primarily affects the musculoskeletal system, liver, and spleen. The condition is characterized by fever, fatigue, and joint pain, and it is commonly transmitted through contact with infected animals or consumption of contaminated animal products.

Causes

Brucellosis due to Brucella abortus is caused by the Brucella abortus bacterium, which is primarily transmitted to humans through direct contact with infected animals (e.g., cattle) or consumption of unpasteurized dairy products from these animals. The bacteria can enter the body through broken skin, mucous membranes, or ingestion.

Risk Factors

• Occupational exposure to livestock or animal products (e.g., farmers, veterinarians).
• Consumption of unpasteurized milk or cheese.
• Travel to regions where Brucella abortus is endemic.
• Handling of infected animal tissues or fluids without proper protection.

Symptoms

• Intermittent or undulating fever.
• Profuse sweating, especially at night.
• Fatigue and weakness.
• Joint and muscle pain (arthralgia/myalgia).
• Headache.
• Loss of appetite and weight.
• Hepatomegaly or splenomegaly in some cases.

Diagnosis

Diagnosis is based on clinical presentation, exposure history, and laboratory testing. Blood or bone marrow cultures may identify Brucella species, while serologic tests (e.g., agglutination tests) can detect antibodies. PCR testing may also be used for confirmation.

Treatment Options

• Antibiotics: Combination therapy with doxycycline and rifampin is commonly used. Alternative regimens may include trimethoprim-sulfamethoxazole or fluoroquinolones.
• Supportive care: Rest and symptom management (e.g., analgesics for pain, antipyretics for fever) may be recommended.
• Duration: Treatment typically lasts 6 weeks or longer, depending on severity and complications.

Prognosis and Follow-Up

With appropriate treatment, most patients recover fully, though some may experience prolonged fatigue or joint pain. Follow-up may include monitoring for relapse or complications, such as endocarditis or osteomyelitis. Chronic infection is rare but possible.

Complications

• Endocarditis (infection of the heart valves).
• Osteomyelitis (bone infection).
• Meningitis or encephalitis (rare).
• Hepatitis or splenic abscesses.
• Recurrent or chronic symptoms in untreated cases.

Lifestyle & Prevention

• Avoid consuming unpasteurized dairy products.
• Use protective gear (e.g., gloves, masks) when handling livestock or animal tissues.
• Practice good hygiene after contact with animals or animal products.
• Vaccinate livestock in endemic areas to reduce transmission risk.

When to Seek Professional Help

Seek medical attention if you experience persistent fever, unexplained fatigue, or joint pain after potential exposure to infected animals or contaminated products. Prompt diagnosis and treatment are important to prevent complications.

Tips for Medical Coders

Code A23.1 is specific to brucellosis caused by Brucella abortus. Documentation should specify the causative organism when available. Ensure the diagnosis aligns with clinical findings and exposure history to support accurate coding.