Recurrent Pyrexia, Brucellosis, Underdiagnosis: The Puzzle Triad Untangled By Blood Cultures - The Benchmark Tool Coming To Aid

ABSTRACT

Introduction: Human brucellosis, a zoonotic disease is common in India. In spite of high prevalence, the disease usually remains under diagnosed or misdiagnosed.Aim: To evaluate & establish the significance of blood culture for diagnosis of brucellosis.Materials & Method: A study of 10 patients of brucellosis diagnosed by blood culture were evaluated retrospectively, for the various clinical & laboratory profiles, during the period of 2014-17. Results: All the ten patients, positive for brucellosis by blood culture were having history of fever. Other clinical presentations were - abdominal pain (n=6,60%), vomiting (n=5,50%), headache (n=1,10 %), generalized body ache (n=1,10%), anorexia (n=1,10%), joint pain (n=1,10%), cough (n= 1,10%), mild splenomegaly (n=2,20%), mild hepatomegaly (n=1,10%), mild to gross hepatosplenomegaly (n=3,30%). In all the cases, Brucella spp. were recovered from patient's blood culture & identified within 7 days of sample collection. The time-to- detection of BACTEC blood culture system (positive indication) was 3-5 days. Conclusion: A high level of clinical suspicion & proper blood culture remains the gold standard for early diagnosis of brucellosis.