Brucellosis in man. I. Serological diagnosis

Area of Science:

• Medical microbiology
• Infectious diseases
• Epidemiology

Background:

• Febrile splenomegaly is a significant clinical presentation in endemic areas.
• Brucellosis (Malta fever) and enteric fever are common differential diagnoses for febrile splenomegaly in Egypt.
• Accurate serological diagnosis is crucial for effective patient management and public health surveillance.

Purpose of the Study:

• To evaluate the diagnostic utility of tube agglutination (TAT), Coombs, and Widal tests in patients with suspected Malta fever.
• To determine the prevalence of brucellosis and enteric fever among patients presenting with febrile splenomegaly.
• To assess the role of serological tests in differentiating between brucellosis and enteric fever.

Main Methods:

• Blood samples were collected from 50 in-patients with febrile splenomegaly in Sharkia fever hospitals, Egypt.
• Serological tests including tube agglutination (TAT), Coombs test, and Widal test were performed for diagnosis.
• Titers and specific antigen agglutination were recorded for differential diagnosis.

Main Results:

• Tube agglutination (TAT) detected 10% positive for brucellosis, with Coombs test increasing the overall detection rate to 16%.
• The Widal test indicated 14% positive for enteric fever, with specific agglutination patterns observed for typhoid and paratyphoid fevers.
• Coombs test showed positive results in 4.65% of Widal-negative patients, suggesting co-infection or cross-reactivity.

Conclusions:

• Serological testing, combining TAT and Coombs, is effective in diagnosing brucellosis in patients with febrile splenomegaly.
• The Widal test is valuable for identifying enteric fever, aiding in the differential diagnosis of febrile illnesses.
• Integrated serological approaches improve diagnostic accuracy for febrile splenomegaly in regions where brucellosis and enteric fever are endemic.