Kas-İskelet Sistemi Ağrıları İle Seyreden Enfeksiyon Hastalığı: Brusellozis
Özet
Brusellozis, Brucella cinsi bakterilerin neden olduğu zoonotik hücre içi bir enfeksiyondur. Bulaş için kontamine pastörize edilmemiş süt ürünlerinin tüketimi, enfekte aerosollerin solunması ve enfekte hayvanlara mesleki maruziyet önemlidir. Kas-iskelet sistemi ağrıları hastalığın hem komplike olmayan hem de karmaşık formlarının en yaygın, spesifik olmayan semptomlarından biridir. Osteoartiküler tutulum, hastalığın en sık görülen komplikasyonudur. Brusellozis genellikle spesifik olmayan oldukça farklı tablolar ile seyredebildiği için diğer bulaşıcı ve bulaşıcı olmayan hastalıklardan ayırt edilmesi oldukça önemlidir. İnsanlarda brusellozisin mikrobiyolojik tanısında kültüre dayalı yöntemler; rose bengal testi, standart aglütinasyon testi, mikrotüp aglütinasyon testi, 2-merkaptoetanol testi, Coombs antiglobulin aglütinasyon testi, Brucella Coombs jel testi, immün yakalama aglütinasyon testi ve ELISA gibi serolojik testler ve nükleik asit amplifikasyon testleri kullanılmaktadır. Bunların her birinin kendi avantajları ve sınırlamaları vardır. Hastalığın nüks etme ve kronikleşme olasılığını önlemek için uzun süreli kombinasyon tedavileri gerekmektedir. Brusellozisin önlenmesi ve yönetilmesinde aşı uygulamaları ve tek sağlık yaklaşımı oldukça önemlidir.
Brucellosis is a zoonotic intracellular infection caused by bacteria of the Brucella genus. The main routes of transmission include the consumption of contaminated unpasteurized dairy products, inhalation of infectious aerosols, and occupational exposure to infected animals. Musculoskeletal pain is one of the most common nonspecific symptoms in both uncomplicated and complicated forms of the disease. Osteoarticular involvement is the most frequent complication of brucellosis. Because the disease can present with a wide range of nonspecific clinical manifestations, distinguishing it from other infectious and noninfectious diseases is of great importance. Microbiological diagnosis of human brucellosis relies on culture-based methods, serological tests—including the Rose Bengal test, standard agglutination test, microtube agglutination test, 2-mercaptoethanol test, Coombs antiglobulin agglutination test, Brucella Coombs gel test, immunocapture agglutination test, and enzyme-linked immunosorbent assay (ELISA)—as well as nucleic acid amplification tests. Each of these diagnostic methods has its own advantages and limitations. Prolonged combination antimicrobial therapy is required to prevent relapse and chronicity of the disease. Vaccination strategies and the One Health approach play a crucial role in the prevention and management of brucellosis.
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