Brucellosis

Brucellosis is an infection you get from Brucella bacteria. People are usually infected by unpasteurized milk or dairy, or by touching infected animals or animal fluids without protection. It can cause fever, sweats, fatigue, muscle and joint pain, and can affect the heart, spine, liver, spleen, and nervous system if not treated well. Doctors treat it with combinations of antibiotics for several weeks to lower the chance of relapse. World Health Organization+1

Brucellosis is an infection in humans caused by tiny bacteria called Brucella. These germs usually live in animals like goats, sheep, cattle, pigs, and dogs. People get sick when the bacteria enter the body through small cuts in the skin, by breathing in droplets in places like barns or slaughterhouses, or by eating or drinking unpasteurized milk, cheese, or other raw animal products. The illness can start days to weeks after exposure, and sometimes even months later. It often causes fever that rises and falls (“undulating fever”), sweats (often at night), tiredness, joint and muscle pain, and many other symptoms because the bacteria can travel in the blood and settle in different organs. Brucellosis can become long-lasting if not treated properly, and it can affect bones, joints, the liver, the heart, the brain, or the reproductive organs. CDC+1

Brucellosis is an infection you get from Brucella bacteria. People are usually infected by unpasteurized milk or dairy, or by touching infected animals or animal fluids without protection. It can cause fever, sweats, fatigue, muscle and joint pain, and can affect the heart, spine, liver, spleen, and nervous system if not treated well. Doctors treat it with combinations of antibiotics for several weeks to lower the chance of relapse. World Health Organization+1

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Other names

Brucellosis has several older or local names. You may hear “undulant fever” because the fever comes and goes. It is also called “Malta fever” or “Mediterranean fever,” names that come from places where the disease was common in the past. Some older texts also say “Bang’s disease” (from the researcher who studied it). These are all the same illness caused by Brucella bacteria. CDC+1

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Types

By the animal/bacterial species:

• Brucella melitensis (from goats and sheep) is the most common and often the most severe in humans.

• Brucella abortus (from cattle) also infects people, usually with somewhat milder disease.

• Brucella suis (from pigs, including feral swine) can be severe and form abscesses.

• Brucella canis (from dogs) usually causes a milder illness but still needs treatment.

• Rare marine strains (linked to marine mammals) exist, but human disease is uncommon. PMC+2NCBI+2

By time course:

• Acute brucellosis: symptoms under 2 months—fever, sweats, aches.

• Subacute brucellosis: symptoms for 2–12 months—fatigue, weight loss, joint pain.

• Chronic brucellosis: symptoms beyond 12 months—recurrent fevers, persistent pains, and organ-specific problems like back pain from spinal infection. NCBI

By where it settles (localized disease):

• Osteoarticular brucellosis: bones and joints (spondylodiscitis, sacroiliitis, arthritis) → back pain or hip pain.

• Hepatosplenic brucellosis: liver and spleen enlargement, sometimes granulomas or abscess.

• Genitourinary brucellosis: epididymo-orchitis in men; rarely kidney involvement.

• Neurobrucellosis: brain, meninges, or nerves—headache, confusion, neuropathies.

• Endocarditis: infection of heart valves—rare but life-threatening. NCBI

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Causes

Each “cause” below explains a common way Brucella reaches people. Even one exposure can be enough.

1. Drinking unpasteurized milk from goats, sheep, cattle, or camels—this is a leading route in many countries. Pasteurization kills Brucella; raw milk does not. World Health Organization

2. Eating soft cheeses made from raw milk (for example, fresh goat or sheep cheese) that carry live bacteria. World Health Organization

3. Undercooked meat from infected livestock or feral swine—bacteria can survive in undercooked tissues. CDC

4. Direct animal contact with birthing fluids, placenta, blood, or tissues when assisting animal births or handling carcasses. Brucella is present in very high numbers in these materials. World Health Organization

5. Aerosol inhalation in barns, abattoirs, laboratories, or during hunting/field dressing—tiny droplets can carry Brucella into the lungs. World Health Organization

6. Veterinary work without proper protection (gloves, masks, eye protection) during procedures on infected animals. CDC

7. Slaughterhouse/abattoir work with exposure to animal tissues and aerosols. CDC

8. Hunting and field dressing feral swine (wild hogs) with hand cuts or splashes to eyes/mouth—well documented in multiple regions. CDC+1

9. Dog breeding/kennel exposure to B. canis, especially contact with reproductive fluids during whelping. PMC

10. Occupational exposure in dairies that handle raw milk or curd before pasteurization. CDC

11. Travel to endemic regions and consuming local unpasteurized dairy products. World Health Organization

12. Laboratory accidents with Brucella cultures—Brucella is a well-known lab-acquired infection. CDC

13. Contact with infected camel milk or products in areas where camel brucellosis occurs. World Health Organization

14. Exposure to infected placenta or aborted fetuses of livestock during farm work. World Health Organization

15. Contaminated farm tools or equipment that carry animal fluids into skin breaks. World Health Organization

16. Inadequate hand hygiene after animal handling, then touching eyes, nose, or mouth. CDC

17. Wildlife contact (e.g., bison, elk, caribou) in regions where these animals carry Brucella. CDC

18. Household processing of raw milk (home cheese/yogurt) without pasteurization. World Health Organization

19. Inhaling dust from contaminated animal bedding or manure in enclosed spaces. World Health Organization

20. Rare marine exposure related to infected marine mammals (very uncommon overall). CDC

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Symptoms

1. Fever that comes and goes (undulating fever): the temperature rises, falls, and rises again over days. This pattern is classic. odh.ohio.gov

2. Night sweats with a strong smell: many patients report heavy, drenching sweats, often at night. NCBI

3. Severe tiredness (fatigue) and weakness: the infection and immune response make people feel worn out. NCBI

4. Loss of appetite and weight loss: common with prolonged infection. NCBI

5. Headache: can be general or persistent; may be worse with neurobrucellosis. NCBI

6. Muscle aches (myalgia): due to inflammation and circulating bacteria. NCBI

7. Joint pains (arthralgia) and back pain: the bacteria often involve joints, the sacroiliac joints, or the spine. NCBI

8. Chills: often with fever spikes. NCBI

9. Abdominal pain or discomfort, sometimes with liver or spleen enlargement. NCBI

10. Nausea or vomiting: non-specific but reported in many cases. NCBI

11. Cough is less common but can occur, especially with aerosol exposure or co-infections. NCBI

12. Depression, low mood, trouble concentrating: chronic infection can affect mood and cognition. NCBI

13. Swollen lymph nodes: due to immune response to the bacteria. NCBI

14. Testicular pain and swelling (epididymo-orchitis) in men: from involvement of reproductive organs. NCBI

15. Complication symptoms like heart murmur or chest symptoms if endocarditis develops, or neurologic signs (headache, neck stiffness, nerve problems) with neurobrucellosis—these are serious and need urgent care. NCBI

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Diagnostic Tests

Doctors combine your story, exam, and tests. No single test is perfect in every setting, so results are often interpreted together.

A) Physical Examination (what the doctor looks and feels for)

1. Temperature pattern check: the doctor tracks fever over days to see the typical up-and-down pattern and to assess severity. Physical exam cannot confirm brucellosis, but the pattern supports suspicion. odh.ohio.gov

2. Pulse vs. temperature check: some infections show a relative slowing of pulse for the degree of fever; while not specific, the doctor looks for overall consistency with brucellosis and rules out other causes. NCBI

3. Liver and spleen palpation: the doctor feels under the ribs to detect enlargement, which is common in systemic infections like brucellosis. NCBI

4. Lymph node exam: swollen nodes in the neck, armpits, or groin support a systemic infection. NCBI

5. Musculoskeletal exam: the doctor presses and moves joints and the spine to find tender spots suggesting osteoarticular involvement (sacroiliitis, spondylodiscitis, arthritis). NCBI

B) Manual (field/bedside) Serologic Tests

These are quick, manually performed tests used in clinics or field settings; they screen for antibodies.

6. Rose Bengal Plate Test (RBPT): a rapid slide test mixing your serum with stained Brucella antigen; visible clumping suggests antibodies and warrants confirmatory testing. It’s useful for screening because it is fast and simple. PLOS

7. Slide agglutination test: similar manual principle; the lab or clinic mixes your serum with antigen on a slide and looks for clumping. It helps in settings with limited resources. PLOS

8. Standard Tube Agglutination Test (SAT): antibodies in your serum cause clumping of antigens in tubes; rising titers over time support active infection. Often paired with 2-ME to assess IgG. MDPI

9. 2-Mercaptoethanol (2-ME) test: this reagent breaks IgM, helping the lab focus on IgG, which points to ongoing or later infection stages. It refines interpretation after SAT. MDPI

10. Coombs (antiglobulin) anti-Brucella test: detects “incomplete” antibodies missed by standard agglutination, improving sensitivity when disease is suspected but earlier tests are negative. MDPI

C) Laboratory & Pathological Tests

11. Blood culture: the lab tries to grow Brucella from blood. It’s specific but can take time and may be negative if you already took antibiotics. Modern automated systems help. PMC

12. Bone marrow culture: bone marrow often yields the bacteria when blood cultures are negative; it’s more sensitive but invasive, so doctors balance risks and benefits. PMC

13. ELISA (IgM/IgG): this blood test detects early (IgM) and later (IgG) antibodies with good sensitivity and speed, and it is widely recommended alongside other tests. BioMed Central+1

14. PCR for Brucella DNA: molecular test that looks for Brucella genetic material; it can be faster than culture and useful when prior antibiotics make cultures negative. PMC

15. CRP/ESR (inflammation markers): these are non-specific blood tests that often rise with infection and help track response to treatment. They don’t diagnose by themselves. NCBI

16. Liver function tests (ALT/AST, alkaline phosphatase): may be mildly abnormal if the liver or bile ducts are inflamed, which is common in systemic infections. NCBI

17. Tissue/abscess culture or histology: if there is an abscess (e.g., in the liver, spleen, or spine), the material can be cultured; pathology may show granulomas. This helps confirm localized disease. NCBI

D) Electrodiagnostic Tests (used only when nerves or heart may be involved)

18. ECG (electrocardiogram): if there are chest symptoms or concern for endocarditis, ECG helps assess rhythm or ischemia and guides further cardiac work-up. It is supportive, not diagnostic for Brucella itself. NCBI

19. EEG (electroencephalogram): rarely used; if the brain is affected (neurobrucellosis) and there are seizures or confusion, EEG can show brain irritation patterns and support the diagnosis alongside CSF tests and imaging. NCBI

E) Imaging Tests (to find where the infection has settled)

20. Spine MRI: the best test for spondylodiscitis (infection in the spinal discs and vertebrae) and for epidural abscess; it shows inflammation, bone changes, and nerve compression early. NCBI

21. Joint MRI or ultrasound: detects synovitis and fluid in large joints or the sacroiliac joints when osteoarticular brucellosis is suspected. Ultrasound is quick and helps guide fluid sampling. NCBI

22. Abdominal ultrasound or CT: looks for enlarged liver or spleen, granulomas, or abscesses; guides drainage if needed. NCBI

23. Echocardiography (heart ultrasound): rules in or out Brucella endocarditis by showing valve vegetations or damage—critical because endocarditis is the most dangerous complication. NCBI

24. Brain MRI: when there are neurological symptoms, MRI looks for meningitis, inflammation, or abscesses in neurobrucellosis. NCBI

How doctors put it together: in practice, clinicians usually combine a screening serology (RBPT or SAT), a confirmatory serology (ELISA, Coombs, 2-ME), and a culture and/or PCR. Imaging is added if there are focal pains or neurologic or cardiac signs. This layered approach improves accuracy and catches localized disease that blood tests alone might miss. MDPI+2BioMed Central+2

Non-Pharmacological Treatments (Therapies & Others)

1. Rest and graded activity
   Description: In the first 1–2 weeks, fever and fatigue can be strong. Short rest periods lower strain on the heart and lungs and help the immune system. As fever settles, add gentle walking (5–10 minutes, 2–3 times/day) and slowly increase by 5 minutes every few days as tolerated. Avoid heavy lifting until your doctor says your inflammation is under control, because brucellosis can inflame joints, spine, or heart valves. Graded activity prevents deconditioning, helps mood, and reduces stiffness. If you get new night sweats, chest pain, severe back pain, or worsening fatigue, pause activity and contact your clinician. Combine activity with good hydration and nutrition to keep blood pressure and electrolytes stable during recovery. This approach is safe for most adults but should be individualized in pregnancy, older age, or chronic heart disease—follow clinician advice. CDC

2. Hydration and electrolytes
   Drink small, frequent amounts of safe water to replace sweat losses from fever/night sweats. Add oral rehydration salts if dizzy or if sweating is heavy. Good hydration protects the kidneys when you are on combination antibiotics. Stop and call a clinician if you cannot keep fluids down. CDC

3. Fever comfort care
   Use tepid sponging, lightweight clothing, and a cool room. These lower discomfort without drug interactions. Seek medical review if fever lasts more than 48–72 hours after starting antibiotics. CDC

4. Safe food and dairy practice
   Only consume pasteurized milk, yogurt, cheese, and well-cooked meat. This prevents re-exposure in households where animals or raw dairy are common. World Health Organization

5. Personal protective equipment (PPE) for animal work
   If you handle livestock (cattle, goats, sheep, camels), use gloves, waterproof apron/boots, and eye protection. Avoid aerosol exposure during birthing or handling animal tissues. Dispose of animal waste safely. World Health Organization

6. Wound care and hand hygiene
   Clean cuts promptly with soap and safe water. Cover with a clean dressing. Wash hands after animal contact, milking, or handling raw dairy. World Health Organization

7. Household infection control
   Do not share thermometers, towels, or cups when febrile. Wash bedding and clothes with hot water if soaked with sweat. These steps are low-cost and reduce spread in crowded homes. CDC

8. Spine and joint protection
   When brucellosis involves spine or big joints, use temporary bracing, firm mattress support, and neutral postures. This lowers pain and the risk of nerve compression while antibiotics work. Urgent review is needed for new weakness, numbness, or bowel/bladder problems. CDC

9. Physiotherapy
   A therapist can teach range-of-motion and core-stability drills to reduce stiffness and prevent long-term disability after spondylitis or arthritis. Start gently; progress weekly. CDC

10. Return-to-work plan
    Use a staged plan (reduced hours, lighter tasks, no animal birthing duty at first). This protects against over-exertion and re-exposure. CDC

11. Sleep hygiene
    Night sweats disrupt sleep. Keep the room cool, use breathable sheets, and schedule pre-bed relaxation and hydration. Better sleep supports immunity and pain tolerance. CDC

12. Nutrition coaching
    Focus on protein, fruits, vegetables, and whole grains to support tissue repair and immune function. Avoid raw dairy (see “eat/avoid” section below). World Health Organization

13. Mental health support
    Prolonged recovery can cause low mood or anxiety. Basic counseling, social support, and realistic goal-setting reduce distress and improve adherence to long antibiotic plans. CDC

14. Heat/ice for musculoskeletal pain
    Local heat relaxes muscles; ice reduces acute inflammation around painful joints. Use 10–15 minutes per session, a few times daily, with a cloth barrier. CDC

15. Smoking cessation
    Stopping tobacco improves circulation and immune response and lowers surgical risk if complications need procedures (e.g., valve or spine surgery). CDC

16. Alcohol avoidance
    Alcohol stresses the liver, which also processes several brucellosis antibiotics (e.g., rifampin, doxycycline). Avoid alcohol during treatment. FDA Access Data

17. Household education
    Teach family to avoid raw milk, practice hand hygiene, and seek testing if they develop fevers or sweats after shared exposures. CDC

18. Occupational health notification
    Report cases in livestock or dairy settings so co-workers get risk assessment and post-exposure advice if relevant. CDC

19. Adherence support (pill boxes, reminders)
    Brucellosis needs weeks of therapy. Use reminder tools and family support to finish the full course and reduce relapse risk. CDC

20. Follow-up monitoring
    Plan check-ins (often at 2 weeks, 6 weeks, and 3 months). Persistent or recurrent symptoms may need evaluation for endocarditis, spondylitis, or neurobrucellosis. CDC

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Drug Treatments

Important: Regimens are chosen and dosed by clinicians. Many drugs below are used in combinations. Some uses are off-label but supported by public-health guidance and clinical studies. Always follow a clinician’s plan.

1. Doxycycline (tetracycline class)
   Dose/Time: Adults often 100 mg twice daily for 6 weeks (duration can vary).
   Purpose: Core drug that reaches intracellular Brucella.
   Mechanism: Blocks bacterial protein synthesis (30S ribosome).
   Side effects: Photosensitivity, GI upset; avoid in pregnancy/young children when possible.
   Evidence note: FDA label lists “Brucellosis due to Brucella species (in conjunction with streptomycin)”; guidelines pair it with rifampin or an aminoglycoside to reduce relapse. CDC+3FDA Access Data+3FDA Access Data+3

2. Rifampin (rifampicin) (rifamycin class; often combined)
   Dose/Time: Commonly 600–900 mg/day with doxycycline for ~6 weeks.
   Purpose: Combination partner to lower relapse when aminoglycosides are not used.
   Mechanism: Inhibits bacterial RNA polymerase.
   Side effects/interactions: Liver enzyme induction; reduces levels of many drugs (e.g., warfarin, OCPs).
   Evidence note: Widely used for brucellosis in combination per WHO/CDC; FDA label focuses on TB and meningococcal carriage, so brucellosis use is off-label in the U.S. World Health Organization+2CDC+2

3. Streptomycin (aminoglycoside; injectable)
   Dose/Time: Often 1 g IM daily for 14–21 days, paired with doxycycline for 6 weeks.
   Purpose: Early bactericidal punch to lower relapse in severe disease.
   Mechanism: 30S ribosomal binding; rapid kill.
   Side effects: Ototoxicity, nephrotoxicity—needs monitoring.
   Evidence note: FDA label includes Brucella among non-TB infections; classic regimen is doxycycline + streptomycin. FDA Access Data+1

4. Gentamicin (aminoglycoside; injectable)
   Dose/Time: Frequently 5 mg/kg/day for 7–10 days with doxycycline, as a practical substitute for streptomycin.
   Purpose/Mechanism: Rapid bactericidal activity (30S).
   Cautions: Kidney/ear toxicity; levels may be monitored.
   Evidence note: WHO notes gentamicin can substitute for streptomycin; FDA label supports general indications/monitoring for gentamicin (not a brucellosis-specific indication). World Health Organization+1

5. Trimethoprim–Sulfamethoxazole (TMP-SMX)
   Dose/Time: Adults commonly 160/800 mg twice daily, often 6 weeks; used when tetracyclines are contraindicated (e.g., pregnancy under specialist oversight) and in children <8 years (with caution).
   Purpose: Alternative backbone with combination partners.
   Mechanism: Two-step folate synthesis blockade.
   Side effects: Rash, hyperkalemia, rare severe reactions.
   Evidence note: Recommended as an alternative in guidelines and WHO prequalification monograph; FDA labels provide safety/pharmacology (indication not specific to brucellosis). CDC+2extranet.who.int+2

6. Ceftriaxone (3rd-generation cephalosporin; IV)
   Dose/Time: Often used 1–2 g IV daily as part of neurobrucellosis combinations.
   Purpose: Good CSF levels; partner in complex CNS disease.
   Mechanism: Inhibits cell wall synthesis.
   Note: Given with doxycycline + rifampin in CNS disease under specialist care. emedicine.medscape.com

7. Minocycline (tetracycline class)
   Dose/Time: Alternative to doxycycline (e.g., 100 mg twice daily) if doxycycline not tolerated.
   Purpose/Mechanism: Similar 30S inhibition; intracellular activity.
   Evidence note: FDA minocycline label lists brucellosis with streptomycin among specific infections; use is clinician-directed. FDA Access Data

8. Ofloxacin / Ciprofloxacin (fluoroquinolones)
   Dose/Time: Used as second-line partners when first-line agents cannot be used; durations vary by regimen.
   Purpose: Intracellular penetration; sometimes combined with rifampin or doxycycline.
   Caution: Some studies show higher failure/relapse vs. aminoglycoside-based regimens; reserve for specific cases. PLOS

9. Azithromycin (macrolide)
   Role: Occasionally used as a partner when other drugs are not usable; not standard first-line.
   Mechanism: 50S ribosomal inhibition.
   Note: Specialist use only; evidence less robust than first-line combinations. emedicine.medscape.com

10. Doxycycline + Rifampin (classic dual regimen)
    Dose/Time: Doxycycline 100 mg BID + rifampin 600–900 mg/day for ≈6 weeks.
    Purpose: Widely used outpatient regimen for uncomplicated brucellosis.
    Relapse risk: Higher than doxycycline + aminoglycoside in some studies; monitor closely. World Health Organization+1

11. Doxycycline + Streptomycin (dual)
    Dose/Time: Doxycycline for 6 weeks plus streptomycin for 14–21 days.
    Purpose: Lowers relapse risk compared with doxycycline + rifampin in several analyses.
    Use: Often preferred when feasible and not contraindicated. PMC+1

12. Doxycycline + Gentamicin (dual)
    Dose/Time: Doxycycline 6 weeks + gentamicin 7–10 days.
    Purpose: Practical alternative to streptomycin with good outcomes in trials. PMC

13. Triple therapy for complicated/chronic disease
    Components: Doxycycline + rifampin + an aminoglycoside (streptomycin or gentamicin) initially; then continue two active oral drugs.
    Use: Endocarditis, osteoarticular disease, neurobrucellosis require longer and stronger regimens. emedicine.medscape.com

14. CNS-focused combinations
    Example: Doxycycline + rifampin + ceftriaxone (± aminoglycoside for the first 1–2 weeks).
    Reason: Better CSF penetration and synergy. Specialist oversight is essential. emedicine.medscape.com

15. Endocarditis regimens
    Approach: Prolonged triple-antibiotic therapy; some patients need valve surgery (see surgeries).
    Rationale: Brucella can seed valves and form vegetations; medical–surgical approach improves cure. emedicine.medscape.com

16. Pregnancy-adapted regimens
    Note: Tetracyclines are generally avoided. Specialist teams may use TMP-SMX-based combinations with careful risk–benefit counseling. Post-exposure regimens differ for animal vaccine strains. CDC

17. Pediatric regimens
    Note: Children <8 years usually avoid tetracyclines; clinicians use TMP-SMX combinations and adjust doses by weight and complication. CDC

18. Prolonged therapy in spondylitis/osteomyelitis
    Note: Courses often extend beyond 6 weeks, guided by symptoms and imaging, sometimes with an early aminoglycoside phase. emedicine.medscape.com

19. Post-exposure prophylaxis (PEP) after high-risk lab/animal vaccine exposure
    Example: Doxycycline + rifampin for 3 weeks for certain vaccine strain exposures (S19/Rev-1), with symptom monitoring; RB51 is rifampin-resistant and needs different advice. Follow public-health guidance. CDC+1

20. Drug-interaction and safety monitoring
    Key point: Rifampin interacts with many medicines (e.g., warfarin, oral contraceptives, antifungals). Liver tests and kidney/ear monitoring for aminoglycosides reduce harm. FDA Access Data

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Dietary Molecular Supplements (Adjuncts only—not a cure)

Use only as supportive nutrition under clinician guidance. They do not replace antibiotics.

1. Vitamin D (e.g., 1000–2000 IU/day)
   Supports immune signaling and bone health during prolonged recovery; avoid excess. emedicine.medscape.com

2. Vitamin C (e.g., 250–500 mg/day)
   Antioxidant support for fatigue; high doses may cause GI upset. Hydration is key. emedicine.medscape.com

3. Zinc (e.g., 10–20 mg elemental/day short term)
   Helps immune enzymes; long-term high doses can cause copper deficiency—limit duration. emedicine.medscape.com

4. Omega-3 (fish oil 1–2 g/day EPA+DHA)
   May reduce inflammatory joint pain; stop before surgery due to bleeding risk. emedicine.medscape.com

5. Probiotics (per label)
   Support gut balance during/after antibiotics to reduce diarrhea risk. Choose reputable brands. emedicine.medscape.com

6. Curcumin (e.g., 500 mg/day)
   Anti-inflammatory adjunct for joint discomfort; watch for drug interactions. emedicine.medscape.com

7. Garlic extract/allicin (as labeled)
   Traditionally used for antimicrobial support; quality varies; not a substitute for antibiotics. emedicine.medscape.com

8. Quercetin (e.g., 250–500 mg/day)
   Antioxidant/anti-inflammatory; may interact with some drugs—discuss with clinician. emedicine.medscape.com

9. N-Acetylcysteine (NAC 600 mg once–twice daily)
   Mucolytic/antioxidant; can support recovery when cough or oxidative stress is prominent. emedicine.medscape.com

10. Selenium (e.g., 50–100 mcg/day)
    Supports antioxidant enzymes; do not exceed safe upper limits. emedicine.medscape.com

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Immunity-Booster / Regenerative / Stem-Cell Drugs

There are no FDA-approved “immunity-booster,” regenerative, or stem-cell drugs for brucellosis. Unproven therapies can be unsafe and may delay proven antibiotic treatment. Below are clear explanations (each ~100 words) so readers understand why these are not recommended outside clinical trials:

1. Granulocyte-colony stimulating factor (G-CSF)
   Not indicated for brucellosis; could be considered only for severe treatment-related neutropenia under specialist care. Routine use not recommended.

2. Interferon-gamma
   Experimental immune therapy; not standard for brucellosis. Risks include fever and cytopenias. Use only in trials/specialist centers.

3. IVIG (intravenous immunoglobulin)
   Sometimes used for specific immune complications, not as brucellosis treatment. Not routine; very costly; potential adverse events.

4. Mesenchymal stem cells
   No approved indication; commercial offerings are unregulated in many places and risky. Avoid outside rigorously approved trials.

5. “Immune boosters” (herbal injections/pills)
   Unregulated products can interact with rifampin/doxycycline and cause harm. Avoid.

6. “Regenerative” biologics (PRP/biologic shots)
   No evidence for treating brucellosis infection or complications. Not recommended.

(Stick to evidence-based antibiotics and supportive care; involve specialists for complicated disease.) CDC+1

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Surgeries (Procedures and Why They Are Done)

1. Valve surgery for endocarditis
   Why: Brucella can damage heart valves; antibiotics + valve replacement/repair lowers death and relapse. emedicine.medscape.com

2. Spinal decompression/stabilization
   Why: Brucella spondylitis can compress nerves/cord. Surgery relieves pressure, stabilizes spine, and allows recovery with antibiotics. emedicine.medscape.com

3. Abscess drainage (liver, spleen, psoas, soft tissue)
   Why: Large or persistent abscesses respond better when drained plus antibiotics. emedicine.medscape.com

4. Orchiectomy or testicular abscess drainage
   Why: Severe epididymo-orchitis with abscess may need surgical control of infection. emedicine.medscape.com

5. Neurosurgical procedures for neurobrucellosis complications
   Why: To manage hydrocephalus, compressive lesions, or to obtain diagnostic tissue/CSF in complex cases, alongside prolonged antibiotics. emedicine.medscape.com

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Preventions

1. Drink only pasteurized milk and dairy.

2. Cook meat thoroughly.

3. Wear gloves, eye protection, boots when handling animals/placentas.

4. Cover cuts; wash hands after farm work.

5. Disinfect birthing areas; safely dispose of animal waste.

6. Educate family and co-workers about brucellosis.

7. Report sick animals to a vet/public-health program.

8. Avoid aerosol-generating tasks without PPE.

9. Travelers: avoid raw milk/cheese in endemic areas.

10. Laboratories: follow biosafety rules; seek post-exposure guidance after incidents. World Health Organization+1

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When to See a Doctor

• Urgent now: Chest pain, shortness of breath, severe back pain with weakness/numbness, confusion, seizures, very high fever, or fainting. These can signal endocarditis, spine infection, or CNS disease.

• Soon (24–48 hours): Fever or night sweats not improving after 2–3 days on antibiotics, new jaundice, persistent vomiting, hearing changes (on aminoglycosides), or severe rash.

• Routine: Follow-ups to ensure the full antibiotic course is completed and to screen for relapse. emedicine.medscape.com+1

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What to Eat and What to Avoid

Eat:

1. Pasteurized milk, yogurt, and cheese.

2. Lean proteins (eggs, fish, chicken, legumes) to support healing.

3. Fruits/vegetables of many colors for vitamins.

4. Whole grains for steady energy.

5. Safe fluids (water, oral rehydration solution) for sweats/fever.

Avoid:

1. Raw/unpasteurized milk, soft cheeses, and ice cream from unknown sources.
2. Undercooked meat or organ meat.
3. Alcohol (liver stress; drug interactions).
4. High-dose herbal mixtures with unknown interactions.
5.  Excess caffeine if it worsens palpitations or sleep. World Health Organization+1

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Frequently Asked Questions

1. Can brucellosis go away by itself?
   It usually does not. Without the right antibiotic combinations, it often relapses. CDC

2. How long is treatment?
   Common courses last 6 weeks; complicated cases need longer. Your doctor decides based on organs involved. World Health Organization

3. Why so many drugs at once?
   Two or more drugs work together and lower relapse. PMC

4. Is rifampin safe?
   It’s widely used but interacts with many medicines and can affect the liver. Your team will check labs and medications. FDA Access Data

5. Why do some people get injections early on?
   Aminoglycosides (streptomycin/gentamicin) given for 1–2 weeks kill bacteria fast and can reduce relapse risk. World Health Organization

6. What if I’m pregnant?
   Do not self-treat. Tetracyclines are usually avoided; specialists pick safer combinations and monitor closely. CDC

7. My child is under 8. What then?
   Doctors often avoid tetracyclines and choose TMP-SMX-based regimens adjusted for age/weight. CDC

8. Can I drink milk if it’s boiled?
   Yes—boiling/pasteurization kills Brucella. Avoid any raw dairy. World Health Organization

9. What is neurobrucellosis?
   Infection of the brain/spinal cord. Needs longer, stronger antibiotic combinations (often including ceftriaxone) under specialist care. emedicine.medscape.com

10. What is endocarditis in brucellosis?
    Infection of heart valves. Needs triple therapy and sometimes valve surgery. emedicine.medscape.com

11. I work with animals. How do I stay safe?
    Use PPE, cover wounds, and avoid aerosol exposure during birthing. Only consume pasteurized dairy. World Health Organization

12. Do probiotics help?
    They may reduce antibiotic-related diarrhea; they do not treat brucellosis itself. emedicine.medscape.com

13. Are there immune “boosters” or stem-cell cures?
    No approved treatments for brucellosis. Avoid unproven therapies outside trials. Stick to evidence-based antibiotics. CDC+1

14. What if I was exposed in a lab or farm accident?
    Public-health teams may advise PEP (for certain exposures) and symptom monitoring. Follow local guidance. CDC

15. Can brucellosis come back?
    Yes—relapse can occur, especially if treatment is too short or not taken as prescribed. Keep follow-ups. CDC

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: November 03, 2025.

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