BRUCELLOSIS-AN UNDER-ESTIMATED CAUSE OF ARTHRALGIA & MUSCULAR PAINS IN GENERAL POPULATION

Inayat Ullah Diju

Abstract


Background: Muscular pains, arthralgias and arthritis are among the most common symptoms of the
patients attending various OPDs and private clinics every day. While the symptoms could be due to a
broad spectrum of the illnesses; the infection with Brucella, often overlooked, is one among such
causes. The objective of present study is to determine the extent to which this infection contributes
towards the presence of such symptoms, and how important it is to rule out this treatable cause in our
society, before labelling and treating these as non-specific aches and pains. Methods: This prospective
study was conducted on 280 patients at a registered medical specialist clinic between May 2006 and
June 2008. The patients of each gender from age 15 years onwards having the symptoms of chronic
muscular pains, backache, and arthralgias etc. were included in the study. The exclusion criteria were
clear cut bone and joint diseases, connective tissue and systemic disorders. The patients were subjected
to evaluation by history taking that especially looked into their involvement with cattle look-after and
also the use of milk and other dairy items. The investigations included agglutination test for Brucella.
The positive cases were treated and the results followed for satisfactory or mild responses. Results: Out
of 280 cases 55 (19.64%) were suffering from infection with Brucella. The above patients had received
non-specific treatment with analgesics or even steroids with no benefit. The young females
outnumbered males, and rural cases had more incidence than urban; and there was a slight increase in
those cases who handled the cattle at home as compared to those who did not. Conclusion: In absence
of a good veterinary care of live stock in societies like that of Pakistan , it becomes important to rule
out Brucellosis, before labelling the symptoms of a patient as simple, non specific aches and pains;
and therefore depriving the patient of a treatable disease if he had one.
Keywords: Brucellosis, Myalgias, Arthralgias, Fever, Dairy, Cattle

References


Park K. Textbook of Preventive & Social Medicine. 23rd ed.

Jabalpur India: Banarasidas Bhanot Publisher; 2002. p. 220–1.

Gladwin M, Trattler B. Clinical Microbiology Made

Ridiculously Simple. Miami: Med Master Inc; 2001. p.75–6.

Mukhtar F. Kokab F. Brucella serology in abattoir workers. J

Ayub Med Coll Abbottabad 2008;20(3):57–61.

Dames S, Tonnerre C, Saint S, Jones SR. Clinical problemsolving. “Don’t Know Much about History”. N Engl J Med

;352:2338–42.

Todd WTA, Lockwood DNJ, Nye FJ, Wilkins EGL, Cary

PB. Brucellosis .In: Haslett C, Edwin R. Chilvers,. Boon NA,

Colledge NR. Eds. Infection and Immune failure. Davidson’s

principals and Practice of Medicine. 19th ed. Edinburgh:

Churchill & Livingstone; 2002. p.19.

Henry F.Chambers,MD. Infectious Diseases: Bacterial &

Chlamydial, In: Current Medical Diagnosis & Treatment.40th

ed. Mc GrawHill; 2001. p.1375.

Warren Levinson. Review of Medical Microbiology &

Immunity 9th Edition. p.157.

Hall HW. Modern chemotherapy for brucellosis in humans.

Rev Infect Dis. 1990;12(6):1060–99.

J Ayub Med Coll Abbottabad 2009;21(2)

http://www.ayubmed.edu.pk/JAMC/PAST/21-2/Inayat.pdf 131

Skalsky K, Yahav D, Bishara J, Pitlik S, Leibovici L, Paul M.

Treatment of human brucellosis: systematic review and metaanalysis of randomised controlled trials. BMJ 2008;336:701–4.

Corbel MJ. Brucellosis in humans and animals; World Health

Organization, 2004. pp 17, 28. Available at: http://www.who.int/

csr/resources/publications/Brucellosis.pdf

Oklahoma State Department of Health. Brucellosis. 10-2006.

Available at: http://ads.health.ok.gov

Maryland Community Health Administration. Brucellosis.

available at: http://www.cha.state.md.us/edcp/vet_med/

brucellosis.html


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]