Brucellosis

A patient with brucellosis may look as though they have an ordinary viral syndrome, an occult bacterial infection, or an inflammatory disease. The pattern that raises suspicion is a persistent or relapsing fever combined with sweats, fatigue, arthralgia or myalgia, hepatosplenomegaly, and a plausible exposure to livestock, wildlife, raw dairy products, or laboratory material. Symptoms establish suspicion, not confirmation. The nurse's early priorities are to identify the exposure, alert the laboratory before specimens are processed, and look for focal disease that changes urgency or treatment duration. Brucella can persist inside macrophages, so therapy is prolonged and uses combination antibiotics rather than a short course of monotherapy. A new murmur, neurologic change, severe focal bone or joint pain, or hemodynamic instability signals possible complicated disease and requires urgent escalation.