A23.2 Brucellosis due to Brucella suis

Name of the Condition

• Brucellosis due to Brucella suis

Summary

Brucellosis due to Brucella suis is a bacterial infection caused by the Brucella suis species, which can affect multiple organ systems. The condition is characterized by fever, fatigue, and musculoskeletal symptoms, and it is often transmitted through contact with infected animals or consumption of contaminated animal products.

Causes

Brucellosis due to Brucella suis is caused by the Brucella suis bacterium, which is primarily transmitted to humans through direct contact with infected animals (e.g., swine) 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 swine or animal products (e.g., farmers, veterinarians).
• Consumption of unpasteurized milk or cheese from infected swine.
• Travel to regions where Brucella suis 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 suis, while serologic tests (e.g., agglutination assays) can detect antibodies. Imaging may be used to assess organ involvement.

Treatment Options

Treatment typically involves a combination of antibiotics, such as doxycycline and rifampin, for several weeks. The specific regimen may vary based on severity and organ involvement. Supportive care, including rest and pain management, may also be recommended.

Prognosis and Follow-Up

With appropriate treatment, most patients recover fully, though some may experience prolonged fatigue or joint pain. Follow-up testing may be necessary to confirm eradication of the bacteria. Chronic infection is rare but can occur in untreated or inadequately treated cases.

Complications

Potential complications include endocarditis, osteomyelitis, or neurobrucellosis. Untreated infection may lead to relapse or persistent symptoms.

Lifestyle & Prevention

• Avoid contact with infected animals or their products.
• Consume only pasteurized dairy products.
• Use protective equipment when handling animal tissues or fluids.
• Practice good hygiene, especially after animal exposure.

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.

Tips for Medical Coders

Document the specific Brucella species (e.g., Brucella suis) when available, as it may impact coding and reporting. Ensure exposure history and clinical findings are clearly recorded to support the diagnosis.