Mediterranean Fever, (Brucellosis) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Most people have heard of Mediterranean Diet but have they heard of Mediterranean Fever?
Mediterranean fever or Brucellosis can be used as a bioterrorism weapon.
Brucellosis is a disease produced by a group of bacteria from the genus Brucella.
These bacteria can cause infection in both humans and animals.
Brucellosis often spread to people who eat contaminated food, which can be raw meat and un-pasteurized milk.
The bacteria can also infect through the air or contact with an open wound.
Brucellosis is an infectious disease that happens from contact with animals carrying brucella bacteria.
The disease derives its names from both its course (undulant fever) and location (Mediterranean Fever, Malta fever, Crimean fever)
Brucella bacteria can be passed to humans if they make contact with infected meat or the placenta of infected animals (cattle, goats, camels, dogs and pigs), or if the human eats or drinks un-pasteurized milk or cheese.
Most cases are produced by the Brucellosis melitensis bacteria.
People working in occupations where they often make contact with animals or meat such as slaughterhouse workers, farmers, and veterinarians are at higher risk.
Luckily, brucellosis is seldom spread from one human to another.
It can be spread through breastfeeding or blood transfusion or sexual contact (rare).
Infection is infrequent without contact with blood or tissue.
Inhalation
Skin or mucosa contact
Consumption of infected or contaminated food
Symptoms are normally non-specific:
Fever
Arthralgia
Back pain
Weakness
Abdominal pain
High fever spikes often happen every afternoon
Fever rises and falls in waves (undulant)
Diagnosis is defined by:
Rose Bengal test (RBT) or serum agglutination test
Isolation of Brucella from blood, bone marrow and liver
Blood brucellosis antigen
Treatment:
Antibiotics, such as doxycycline, streptomycin, gentamicin, and rifampin, are given to treat the infection and stop it from coming back.
Frequently, the patient needs to take the drugs for 6 weeks.
If there are complications from brucellosis, the patient will likely need to take the drugs for a longer period.
Doxycycline-rifampicin-aminoglycoside (triple drug regimen) and longer treatment regimes (>6 weeks) have the least rates of failure.

One study of the treatment of brucellar spondylitis documented that six months of triple therapy were needed to prevent recurrences.
Pregnant Women
Co-trimoxazole has been used in pregnant women with reported success.
Children
In pediatric patients older than 12 years, doxycycline (5 mg/kg/day for three weeks) plus gentamicin (5 mg/kg/day IM for the first five days) is the advised therapy.
For children younger than 12 years, trimethoprim/sulfamethoxazole (TMP-SMZ) for three weeks and a five-day course of gentamicin are most efficacious.
Adults
Doxycycline (100 mg PO bd for six weeks) is the most suitable monotherapy in simple infection; but relapse rates may reach 40% for monotherapy treatment.
Rifampicin (600-900 mg/day) is typically added to doxycycline for a full six-week course.
Doxycycline (six weeks) plus streptomycin (two or three weeks) was a more successful regimen than doxycycline plus rifampicin (six weeks).
Streptomycin requires daily intramuscular injections and is more costly than rifampicin.
In patients with spondylitis or sacroiliitis, doxycycline plus streptomycin (1 g/day IM for three weeks) was found to be more effective than the doxycycline and rifampicin combination.
The quinolone plus rifampicin (6 weeks) regime is somewhat better endured than doxycycline plus rifampicin but there was no difference in efficacy.
Corticosteroids may be indicated in CNS infection.
Most patients resolve completely if treated early.
TABLE OF CONTENT
Introduction
Chapter 1 Mediterranean Fever
Chapter 2 Causes

• Language: English
• Publisher: Kenneth Kee
• Release date: Jul 4, 2017
• ISBN: 9781370365548

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Mediterranean Fever,

(Brucellosis)

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2017 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Mediterranean Fever, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Mediterranean Fever)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank the patient for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Mediterranean Fever (Brucellosis)

Most people have heard of Mediterranean Diet but have they heard of Mediterranean Fever?

Mediterranean fever or Brucellosis can be used as a bioterrorism weapon.

What Is Mediterranean Fever (Brucellosis)?

Brucellosis is a disease produced by a group of bacteria from the genus Brucella.

These bacteria can cause infection in both humans and animals.

Brucellosis often spread to people who eat contaminated food, which can be raw meat and un-pasteurized milk.

The bacteria can also infect through the air or contact with an open wound.

Brucellosis is an infectious disease that happens from contact with animals carrying brucella bacteria.

The disease derives its names from both its course (undulant fever) and location (Mediterranean Fever, Malta fever, Crimean fever).

What are the causes of Brucellosis?

Causes

Brucella bacteria can be passed to humans if they make contact with infected meat or the placenta of infected animals (cattle, goats, camels, dogs and pigs), or if the human eats or drinks un-pasteurized milk or cheese.

Brucellosis is unusual in the USA.

About 100 to 200 cases happen each year.

Most cases are produced by the Brucellosis melitensis bacteria.

People working in occupations where they often make contact with animals or meat such as slaughterhouse workers, farmers, and veterinarians are at higher risk.

The germs localize in the reticuloendothelial cells of liver, spleen, bone marrow, and lymph glands.

Pathogenesis

The pathologenic agent is a Gram-negative, aerobic bacillus (facultative intracellular) which is endemic worldwide, causing disease mainly in domestic animals and later transmitted to man.

The majority of human infections occur from B. melitensis, the most pathogenic species in man, even though B. suis is rising as an agent in cattle and may become more important.

Species affected are:

1. Goats, sheep, camels, foxes, some deer species (Brucella melitensis).

2. Pigs, reindeer, cattle, bison, hares, rodents and various species of deer (B. suis).

3. Cattle, bison,