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    ABSTRACT: An ELISA test for IgG and IgM antibrucella antibodies was found to be effective in diagnosis of human brucellosis. Assays for IgG and IgM in 30 culture-positive cases gave significant ELISA values. By the standard agglutination test, 10% of these cases gave readings less than 1:160. These are considered insignificant, taking 1:160 as the accepted cut-off value. Moreover, in an extra 135 samples from suspected brucella cases, where only serology was requested (77.6% of all cases), 7.4% were found to have IgM brucella antibodies by ELISA. In all of these, the corresponding agglutination titres were less than 1:80 and hence reported as insignificant. We report the detection of IgG and IgM antibodies in samples from patients with both acute and chronic disease. In few patients with acute disease, only IgM was detected. These findings are discussed in comparison with earlier studies. Finally, the ELISA test, in addition to measuring antibody classes directly, also detects incomplete antibodies. By this, it can efficiently replace the 2 mercaptoethanol test (2ME) and the Coomb's antihuman-globulin test. This saves considerable laboratory cost and time.
    Journal of Infection 04/1998; 36(2):197-201. DOI:10.1016/S0163-4453(98)80013-3 · 4.02 Impact Factor
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    ABSTRACT: We reviewed and analyzed sonographic findings in granulomatous epididymo-orchitis in an attempt to differentiate this rare inflammatory entity from other causes of enlarged scrotum, such as tumors. We retrospectively reviewed sonographic features of 9 patients a mean of 41 years old with specific and nonspecific granulomatous epididymo-orchitis, including brucellosis in 7, tuberculosis in 1 and idiopathic granulomatous epididymo-orchitis in 1. Histological confirmation was obtained in 3 cases, and in the remaining 6 positive clinical manifestations and laboratory tests for brucellosis were accepted as the main criteria for the diagnosis of brucellar epididymo-orchitis. The most notable echographic finding was an enlarged and heterogeneous epididymis, predominantly in the body and tail. Testicular involvement consisted of a diffusely hypoechoic testis or focal intratesticular areas. Thickening of the scrotal wall and tunica albuginea, and moderate hydrocele were also noted occasionally. Followup scans revealed intratesticular abscesses in 3 patients. These echographic findings may suggest the diagnosis of granulomatous epididymo-orchitis in the appropriate clinical setting, and help to avoid unnecessary orchiectomy for benign disease.
    The Journal of Urology 07/1998; 159(6):1954-7. DOI:10.1016/S0022-5347(01)63206-3 · 3.75 Impact Factor
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    ABSTRACT: Brucellae are small gram-negative nonmotile coccobacilli which can be isolated as part of the normal flora of the geni- tourinary tract of a variety of wild and domestic animals in- cluding cows, goats, sheep, pigs, and dogs (22, 34). The organ- ism is strictly aerobic, nonencapsulated, and catalase and oxidase positive; it does not ferment carbohydrates and has variable urease activity (34). Based on DNA homology, it has been demonstrated that all six members of the genus are, in fact, serovars of a single species of which four, namely, Brucella abortus, B. suis, B. canis, and especially B. melitensis are able to cause human infections (34). Brucellosis is usually transmitted to humans by direct contact with infected animals or by inges- tion of unpasteurized dairy products (34). In addition, occu- pational exposure of abattoir workers, veterinarians, and lab- oratory technicians may result in transmission of the disease through contaminated aerosols. Brucellae are capable of evading host defense mechanisms, surviving as intracellular organisms, and are able to cause prolonged morbidity, relapses, and long-term sequelae. Bru- cellosis is a systemic infection that may affect any organ system in the body (28, 29, 34). Because of the wide spectrum of its clinical manifestations, brucellosis may mimic other infectious and noninfectious conditions and, therefore, the diagnosis of the disease is frequently delayed or even missed (29, 34). Brucellosis continues to affect large human populations liv- ing in rural areas in Mediterranean, Middle East, and Latin American countries where the organisms are endemic (2, 13, 14, 27-29, 31-34). In developed countries, the incidence of human brucellosis has declined in the last 50 years as the result of infection control measures, and in these countries most cases represent occupational disease, travel-acquired infec- tions, or accidental laboratory exposure (34). Because of the low prevalence of brucellosis in the developed world, microbi- ology laboratories in these regions are frequently unfamiliar with the diagnostic tools available for the isolation of the or- ganism. The purpose of this review is to summarize published information on the performance of blood culture techniques for the detection of Brucella organisms. Because anaerobic conditions do not adequately support the growth of brucellae, only data on the performance of aerobic media will be in- cluded.
    Journal of Clinical Microbiology 12/1999; 37(11):3437-42. · 4.23 Impact Factor
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