title: Treatment of pulmonary brucellosis: a systematic review.
abstract: Pulmonary involvement is a rare, focal complication of human brucellosis. The aim of this review is to describe clinical and radiologic features, treatment administered and clinical course of these patients. Areas covered: We conducted a systematic search of scientific reports of brucellosis with pulmonary involvement published from January 1985 to July 2016. Four main patterns of disease were observed: pneumonia, pleural effusion, nodules and interstitial pattern. Cough and fever were the most common symptoms. Brucella spp. culture was obtained from blood (50%) or pleural fluid. Treatment is based on the same antibiotics and combinations of antibiotics as for patients with acute no complicated brucellosis. The most frequent antimicrobial combination was doxycycline and rifampin for six weeks. The clinical course was favorable in most reports, and mortality was remarkably low (<1%). Expert commentary: Non-specific clinical and radiological manifestations were the main reason for the delay in proper treatment. Difficulty in distinguishing Brucellosis from other pulmonary infections, such as tuberculosis, sometimes posed an added diagnostic challenge.
authors: a Servicio de Medicina Interna , Complejo Hospitalario Universitario de Albacete , Albacete , Spain.|b Departamento de Ciencias Médicas, Facultad de Medicina de Albacete , Universidad de Castilla-La Mancha , Albacete , Spain.
authors: Javier
authors: J
authors: Solera
authors: c Servicio de Medicina Interna , Hospital General de Villarrobledo , Villarrobledo , Spain.
authors: Julián
authors: J
authors: Solís García Del Pozo
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002006:Brucellosis / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D004359:Drug Therapy, Combination; D006801:Humans; D008171:Lung Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D017410:Practice Guidelines as Topic; D012121:Respiration, Artificial
chemical_list: D000900:Anti-Bacterial Agents
keywords: Brucella melitensis; Brucellosis; aminoglycosides; antimicrobial treatment; focal complication; pleural effusion; pulmonary infection; pulmonary patter; rifampin; tetracyclines