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brucellosis examination, brucellosis diagnosis

brucellosis examination, brucellosis diagnosis

Common checks for brucellosis

Inspection Name Inspection Site Inspection Department Inspection Function
Direct anti-human globulin test blood vessel blood direct anti -human globulin ...
Cerebrospinal fluid bacterial culture of the brain - normal human cerebrospinal fluid...
Complement fixation test whole body - complement fixation test...
Blood and bone marrow bacteria culture blood vessels and bone marrow pathology department of blood and bone marrow...
Medical examination

1. Surrounding blood:

The white blood cell count is normal or slightly low, and the lymphocytes are relatively or absolutely increased. The erythrocyte sedimentation rate increases in the acute phase and is also high in the chronic phase. Anemia is unclear, only seen in severe patients or those with prolonged lesions.

2. Bacterial culture:

It takes a long time, and you can give up after 4 weeks if there is still no growth. The positive rate of bone marrow culture is higher than that of blood, especially in the chronic phase. The positive rate of blood culture in patients with acute sheep type can reach 60% to 80%. The initial isolation of Brucella bovis requires 10% carbon dioxide. Bacteria can also be isolated from urine, cerebrospinal fluid, pus, etc. of patients with meningitis, and the specimens can be inoculated into guinea pigs or mice.

3. Immunology test

1] Serum agglutination test:

The test tube method is to directly detect the antibody against lipopolysaccharide antigen, and the titer is ≥1:160 to be positive, but it can also be positive after injection of the chaotic vaccine. Therefore, double serum should be checked. If the titer increases by 4 times or more, it is It suggests a recent brucella infection.

2 】Enzyme-linked immunosorbent test (ELISA):

The positive rate of this method is higher than that of agglutination test, and the sensitivity of detecting IgM and IgG is similar. Since the antibodies of chronic patients are of the IgG type, this method can be used for the diagnosis of acute and chronic patients at the same time. Recently, avidin enzyme-linked test is used, which is more sensitive than ELISA.

3] 2-Mercaptoethanol (2-ME) test:

This method can detect IgG, which is used to distinguish natural infection and bacterial immunity. After 1 month of natural infection, the main body agglutination is IgG type (IgM type at first), and this IgG is tolerant to 2-ME; and the lectins within 3 months after bacterial immunization are all IgM Master, can be destroyed by 2-ME.

4] Replenishment test:

Supplementary antibodies are also IgG, and the effect can exceed 1:16 in the third week of the disease course.

The positive rate of this test is higher than the agglutination test, and the specificity is also higher, but the appearance time is later than the agglutination test.

5] Anti-human globulin test

: The patient can still produce an incomplete antibody. Although the latter can bind to the antigen, it is not visible to the naked eye. When the anti-human globulin immune serum is added to the antigen-incomplete antibody complex, a direct visible reaction occurs. Incomplete antibodies appear early and disappear late, so they can be used for the diagnosis of patients in the acute and chronic phases. In view of the complicated operation of this method, it is only suitable for suspicious patients with negative agglutination test, and the titer is more than 1:80 as positive.

6] Intradermal test:

Brucellin skin test is a delayed hypersensitivity reaction, and the results are observed for 24 to 48 hours. Only local redness and no lumps are negative, and local redness and swelling and hard and fast diameters of 2 to 6 cm are positive. The skin test has a very low positive rate within 6 months of the disease course, and nearly 100% of patients in the chronic phase are positive or strongly positive.

7] Other immune tests:

There are reverse passive hemagglutination tests, radioimmunoassays, indirect immunofluorescence tests, etc., which are not suitable for general use due to their complicated operations.

4. Other inspections:

Cerebrospinal fluid examination is suitable for patients with meningitis. Cerebrospinal fluid cells have increased (mainly lymphocytes), protein has increased, and the rest are normal. Cardiac power production can show the director of PR in the new period, myocardial damage, low voltage and so on. X-ray examination of bones and joints showed soft tissue calcification, strong bone repair response and less destructiveness, and narrowing of intervertebral discs and intervertebral spaces. The changes of liver function and EEG are non-physical.

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