Brucellosi: che cos’è, come si trasmette, prevenzione
Table of Contents
Che cos’è la brucellosi?
La brucellosi è una zoonosi occasionalmente trasmessa all’uomo, causata da diverse specie di Brucella, caratterizzata da una fase acuta con febbre intermittente irregolare e da una successione di fasi febbrili con algie e sudorazioni profuse alternate con remissione di alcune settimane. Caratteristiche salienti della brucellosi sono la grande varietà e l’ aspecificità dei quadri clinici possibili.
Eziologia
Le brucelle sono dei piccoli coccobacilli Gram-, aerobi, mobili e asporigeni. Al genere Brucella appartengono diverse specie:
- Brucella melitensis (ovini): patogena per la capra e la pecora, trasmessa all’uomo dai latticini, provoca la febbre di Malta o melitococcica diffusa allo stato endemico in tutto il Mediterraneo.
- Brucella suis (suini): patogena per il maiale, può essere trasmesso all’uomo e provocare una febbre ondulante frequenza in America.
- Brucella abortus (bovini): patogena per i bovini (mucca, giumenta) nei quali provoca l’aborto epizootico. Trasmissibile all’uomo, provoca la febbre di Bang che è endemica in Europa.
- Brucella canis (cani): in condizioni naturali solo i canidi domestici e selvatici sono serbatoio dell’infezione, che si trasmette per contatto diretto con le mucose genitali, oronasali e congiuntivali.
Come si trasmette la brucellosi?
In relazione alle diverse vie di trasmissione, il bacillo penetra nell’organismo attraverso la cute abrasa o la congiuntiva (contatto diretto con animali infetti), le vie aeree superiori (lavoratori dei mattatoi) e le mucose dell’apparato digerente (ingestione di alimenti contaminati). L’evoluzione dell’infezione dopo la penetrazione delle brucelle nell’organismo è simile a quello osservata nella febbre tifoide; i bacilli colonizzano i linfonodi regionali e da qui disseminano attraverso una fase ematogena a tutti gli elementi del cosiddetto sistema reticolo endoteliale ( milza, linfonodi, midollo osseo, fegato).
Manifestazioni cliniche
Il periodo di incubazione varia da 2 a 8 settimane dal contagio; l’infezione è sistemica e può coinvolgere numerosi apparati.
- Febbre: l’inizio è spesso insidioso con podromi vaghi, accompagnati da elevazioni termiche la sera. La febbre è a volte di tipo ondulante classico, con ondate termiche successive a 39 -40°, da 10 a 20 giorni, con sedazione tra le puntate, senza apiressia franca.
- Sintomi associati: nella fase acuta, algie e sudori soprattutto notturni. Lo stato generale è ben conservato, ma l’astenia è intensa. L’epatomegalia moderata è costante e nella metà dei casi, si ha poliadenopatia. Nella fase subacuta, anoressia, stipsi, insonnia, impotenza, depressione mentale.
- Evoluzione: gli accessi termici si succedono da 3 a 6 volte nei casi non trattati; esistono forme prolungate che durano per anni.
- Forme cliniche: si possono osservare forme acute con inizio brusco, febbre elevata a plateau, brividi,s tato tifoide, delirio. Vi sono anche forme lievi, ambulatoriali. La reinfezione è possibile.
Come si cura la brucellosi
La brucellosi è un’infezione batterica causata da batteri del genere Brucella. È generalmente trasmessa attraverso il consumo di prodotti lattiero-caseari non pastorizzati o attraverso il contatto diretto con animali infetti.
La cura della brucellosi di solito prevede l’uso di antibiotici. I farmaci comunemente prescritti includono:
- Doxiciclina: spesso utilizzata come trattamento di prima linea, di solito in combinazione con un altro antibiotico.
- Rifampicina: spesso somministrata insieme alla doxiciclina per aumentare l’efficacia del trattamento.
- Gentamicina: può essere usata in alcuni casi, specialmente in combinazione con altri antibiotici.
Il trattamento dura generalmente da 6 a 12 settimane, a seconda della gravità dell’infezione e della risposta del paziente. È fondamentale seguire le indicazioni del medico e completare l’intero ciclo di antibiotici per evitare recidive.
In caso di complicazioni, come infezioni osteoarticolari o endocarditi, potrebbero essere necessari trattamenti più intensivi o prolungati.
È sempre consigliato consultare un medico per una diagnosi e un trattamento adeguato.
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