Lab diagnosis of brucellosis

Abstract

Brucellosis is a widespread zoonotic disease posing serious public health problem especially in developing countries. The diagnosis of brucellosis is a greater challenge, as it requires a high index of suspicion, clinical and laboratory evidence of diagnosis. Increased travel across the globe to endemic areas for work and pleasure over the last few years has led to increased diagnostic challenges in non-endemic countries.

Laboratory diagnosis of brucellosis is essential for diagnosis and effective treatment, as it involves two drugs or more for a prolonged period unlike many other infections. Among the various tests available, culture of the organism from the bone marrow, blood and other tissues is the gold standard for diagnosis in brucellosis. However, it is invasive, time consuming and at times less sensitive. These drawbacks have prompted the use of alternate methods to rapidly and accurately diagnose brucellosis and aid in early intervention or therapy.

The alternate methods predominantly include serological tests such as enzyme-linked immunosorbent assay, serum agglutination testing and molecular tests with varying advantages and drawbacks suited to various clinical situations. These tests help not only in diagnosis but also in follow-up of disease activity/response to therapy. This article reviews the various culture methods, serological tests and newer diagnostic methods available in making a laboratory diagnosis of brucellosis along with their advantages and drawbacks.