[Brucellosis after treatment: the diagnosis of recurrences].
BACKGROUND
Given the frequency of relapse following treatment of brucellosis as well as the persistence of symptoms the authors attempted to discover a recommendable position for surveillance of patients once treatment has been completed.


METHODS
A series of 105 patients treated for brucellosis was prospectively analyzed, 11 of whom had relapse. Post treatment symptoms, serology titers and the results of the cultures between the cured patients and those with relapse were compared.


RESULTS
Hemocultures (sensitivity 0.73) and "specific" symptoms (prolonged fever, spondylitis, arthritis, orchitis and others) were the most useful data for diagnosis of relapse. The presence of vague symptoms following treatment was of slight value specially in the first months. Elevation of serology titers following treatment offered little aid in diagnosis (likelihood ratio 1.7). The persistence of high titers of serology several months following completion of treatment offered high likelihood ratios which may aid in therapeutic decision making.


CONCLUSIONS
It is recommended that no tests be made on asymptomatic patients following treatment of brucellosis and to treat those patients with "specific" symptoms. Hemocultures are recommended for patients with vague symptoms and if several months have passed serology should be carried out from which the probability of relapse may be calculated.
Martín Moreno
S
S
Servicio de Medicina Interna, Hospital General de Segovia.
Guinea Esquerdo
L
L
Carrero González
P
P
Visedo Orden
R
R
García Carbajosa
S
S
Calvo del Olmo
T
T
Reverte Cejudo
D
D
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D002002:Brucella / Q000276:immunology / Q000302:isolation & purification; D002003:Brucella abortus / Q000276:immunology / Q000302:isolation & purification; D002006:Brucellosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D013030:Spain / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial
La brucelosis después del tratamiento: diagnóstico de las recidivas.