ICD-10: A23.2

Brucellosis is a zoonotic infection caused by bacteria of the genus Brucella, which can lead to significant health issues in humans. The ICD-10-CM code A23.2 specifically refers to brucellosis due to Brucella suis, a species primarily associated with swine but can also infect humans, particularly those who work with or consume products from infected animals.

Clinical Description of Brucellosis Due to Brucella suis

Etiology

Brucella suis is one of the four main species of Brucella that cause human infections. It is primarily transmitted through direct contact with infected animals, consumption of unpasteurized dairy products, or inhalation of aerosols from infected environments. The bacteria can survive in various environments, making them a persistent threat in agricultural settings.

Symptoms

The clinical presentation of brucellosis can vary widely, ranging from mild to severe. Common symptoms include:

• Fever: Often undulant (intermittent fever that rises and falls).
• Sweats: Profuse sweating, particularly at night.
• Fatigue: General malaise and weakness.
• Muscle and Joint Pain: Myalgia and arthralgia are common complaints.
• Headaches: Persistent headaches may occur.
• Gastrointestinal Symptoms: Nausea, vomiting, and abdominal pain can also be present.

In some cases, brucellosis can lead to more severe complications, including osteoarticular infections, endocarditis, and neurological manifestations.

Diagnosis

Diagnosis of brucellosis due to Brucella suis typically involves:

• Serological Tests: These tests detect antibodies against Brucella species, with the most common being the Rose Bengal test and the standard agglutination test.
• Culture: Isolation of the bacteria from blood or other body fluids is the gold standard for diagnosis, although it can be time-consuming and requires specialized laboratory conditions.
• Molecular Methods: PCR (polymerase chain reaction) can be used for rapid identification of Brucella DNA in clinical samples.

Treatment

The treatment of brucellosis generally involves a combination of antibiotics. The most commonly used regimens include:

• Doxycycline: Often combined with rifampin or streptomycin for a more effective treatment.
• Rifampin: Used in conjunction with other antibiotics to enhance efficacy.
• Streptomycin: An aminoglycoside antibiotic that may be used in severe cases.

The duration of treatment typically ranges from six weeks to three months, depending on the severity of the disease and the presence of complications.

Prevention

Preventive measures are crucial in controlling brucellosis, especially in endemic areas. These include:

• Vaccination: Vaccination of livestock can significantly reduce the incidence of Brucella infections in animals.
• Food Safety: Avoiding unpasteurized dairy products and ensuring proper cooking of meat can help prevent transmission.
• Occupational Safety: Individuals working in agriculture or veterinary fields should use protective equipment to minimize exposure.

Conclusion

Brucellosis due to Brucella suis is a significant public health concern, particularly in regions where swine farming is prevalent. Understanding its clinical presentation, diagnostic methods, and treatment options is essential for effective management and prevention of this zoonotic disease. The ICD-10-CM code A23.2 serves as a critical identifier for healthcare providers in diagnosing and treating this condition, ensuring appropriate care and reporting.

Brucellosis is a zoonotic infection caused by bacteria of the genus Brucella, with Brucella suis being one of the species responsible for human infections. The clinical presentation of brucellosis can vary significantly, and understanding the signs, symptoms, and patient characteristics associated with this condition is crucial for diagnosis and management.

Clinical Presentation of Brucellosis Due to Brucella suis

Signs and Symptoms

1. Fever:
   - The most common symptom is an undulant fever, which can be intermittent or persistent. Patients often experience fluctuating temperatures that may reach high levels, typically between 38°C to 40°C (100.4°F to 104°F) [1].

2. Sweats:
   - Profuse sweating, particularly at night, is frequently reported by patients, contributing to discomfort and sleep disturbances [1].

3. Fatigue and Malaise:
   - Patients often describe a general feeling of unwellness, fatigue, and weakness, which can persist for weeks or months [1].

4. Musculoskeletal Pain:
   - Joint and muscle pain are common, with arthritis or spondylitis occurring in some cases. This can lead to significant discomfort and mobility issues [1][2].

5. Gastrointestinal Symptoms:
   - Nausea, vomiting, abdominal pain, and diarrhea may occur, although these are less common than systemic symptoms [1].

6. Respiratory Symptoms:
   - Cough and chest pain can occur, particularly if the infection spreads to the lungs, although this is rare [1].

7. Neurological Symptoms:
   - In some cases, brucellosis can affect the central nervous system, leading to symptoms such as headaches, confusion, or meningitis [1][2].

8. Reproductive Symptoms:
   - In men, orchitis (inflammation of the testicles) can occur, while women may experience complications related to pregnancy [1].

Patient Characteristics

1. Occupational Exposure:
   - Individuals working in agriculture, veterinary medicine, or those who handle livestock are at higher risk due to potential exposure to infected animals or contaminated animal products [1][2].

2. Geographic Distribution:
   - Brucellosis is more prevalent in certain regions, particularly in areas where livestock farming is common, such as parts of the Mediterranean, the Middle East, and Latin America [1].

3. Age and Gender:
   - While brucellosis can affect individuals of any age, it is most commonly diagnosed in adults. Males are more frequently affected than females, likely due to occupational exposure [1][2].

4. Immunocompromised Status:
   - Patients with weakened immune systems may experience more severe manifestations of the disease and are at higher risk for complications [1].

5. History of Consumption:
   - A history of consuming unpasteurized dairy products or undercooked meat from infected animals can be a significant risk factor for developing brucellosis [1][2].

Conclusion

Brucellosis due to Brucella suis presents with a range of symptoms, primarily characterized by fever, sweats, fatigue, and musculoskeletal pain. Understanding the clinical presentation and patient characteristics is essential for timely diagnosis and treatment. Given the zoonotic nature of the disease, awareness of occupational and dietary risks is crucial for prevention and management strategies. If you suspect brucellosis, especially in at-risk populations, prompt medical evaluation and appropriate laboratory testing are recommended to confirm the diagnosis and initiate treatment.

Brucellosis due to Brucella suis, classified under ICD-10 code A23.2, is a specific type of brucellosis caused by the Brucella suis bacterium. This condition is primarily associated with infections that can occur in humans through contact with infected animals or consumption of contaminated animal products. Below are alternative names and related terms for this condition:

Alternative Names

1. Swine Brucellosis: This term emphasizes the association of the disease with swine (pigs), which are the primary reservoir for Brucella suis.
2. Brucellosis Type 2: Sometimes used in clinical settings to differentiate it from other types of brucellosis caused by different Brucella species.
3. Brucella suis Infection: A straightforward term that specifies the causative agent of the infection.

Related Terms

1. Brucellosis: A general term for infections caused by any species of the Brucella genus, which includes Brucella abortus, Brucella melitensis, and Brucella canis, in addition to Brucella suis.
2. Zoonotic Infection: Brucellosis is classified as a zoonotic disease, meaning it can be transmitted from animals to humans.
3. Undulant Fever: A term sometimes used to describe the fluctuating fever that can occur in brucellosis cases.
4. Brucella spp.: Refers to the various species of the Brucella bacteria, which can cause similar clinical presentations.
5. Brucellosis due to Brucella suis: This is a more descriptive term that specifies the causative agent and the type of brucellosis.

Clinical Context

Brucellosis due to Brucella suis is particularly relevant in veterinary and public health contexts, especially in regions where swine farming is prevalent. Understanding the alternative names and related terms can aid healthcare professionals in diagnosing and treating this infection effectively.

In summary, the ICD-10 code A23.2 encompasses a specific form of brucellosis that is crucial for accurate medical coding and epidemiological tracking. Recognizing the various terms associated with this condition can enhance communication among healthcare providers and improve patient care.

Brucellosis, particularly when caused by Brucella suis, is classified under the ICD-10 code A23.2. This zoonotic infection primarily affects livestock and can be transmitted to humans, leading to a range of clinical symptoms. The diagnosis of brucellosis due to Brucella suis involves several criteria, which can be categorized into clinical, laboratory, and epidemiological factors.

Clinical Criteria

1. Symptoms: Patients typically present with a variety of symptoms, which may include:
   - Fever (often undulant)
   - Sweats
   - Fatigue
   - Joint pain (arthralgia)
   - Muscle pain (myalgia)
   - Headaches
   - Weight loss
   - Abdominal pain

2. History of Exposure: A significant aspect of the diagnosis is the patient's history, particularly:
   - Contact with infected animals, especially swine.
   - Consumption of unpasteurized dairy products or undercooked meat from infected animals.

Laboratory Criteria

1. Serological Tests: The diagnosis is often confirmed through serological testing, which may include:
   - Rose Bengal Test: A rapid agglutination test that detects antibodies against Brucella species.
   - Enzyme-Linked Immunosorbent Assay (ELISA): More specific tests that can confirm the presence of antibodies.

2. Culture: Isolation of Brucella suis from blood, bone marrow, or other body fluids is the gold standard for diagnosis. However, cultures can take time and may not always be positive.

3. Molecular Testing: Polymerase chain reaction (PCR) tests can be used to detect Brucella DNA in clinical specimens, providing a rapid and specific diagnosis.

Epidemiological Criteria

1. Geographical Considerations: The prevalence of Brucella suis infections is higher in certain regions, particularly where swine farming is common. Knowledge of local epidemiology can aid in diagnosis.

2. Outbreaks: Awareness of recent outbreaks or clusters of brucellosis cases in a community can also support the diagnosis.

Conclusion

The diagnosis of brucellosis due to Brucella suis (ICD-10 code A23.2) relies on a combination of clinical symptoms, laboratory findings, and epidemiological context. Clinicians should consider these criteria when evaluating patients with suspected brucellosis, especially in areas where the disease is endemic or in individuals with relevant exposure history. Early diagnosis and treatment are crucial to prevent complications associated with this infection.

Brucellosis, particularly that caused by Brucella suis, is a zoonotic infection that primarily affects livestock and can be transmitted to humans. The ICD-10 code A23.2 specifically refers to brucellosis due to this particular species of Brucella. Understanding the standard treatment approaches for this condition is crucial for effective management and recovery.

Overview of Brucellosis

Brucellosis is characterized by a range of symptoms, including fever, sweats, malaise, anorexia, headache, and muscle pain. The disease can lead to more severe complications if not treated promptly, including osteoarticular infections, endocarditis, and neurological issues[1]. Brucella suis is particularly associated with infections in swine and can cause more severe disease in humans compared to other Brucella species[2].

Standard Treatment Approaches

Antibiotic Therapy

The cornerstone of treatment for brucellosis is antibiotic therapy. The following regimens are commonly recommended:

1. Doxycycline and Rifampin: A standard treatment regimen includes doxycycline (100 mg orally twice daily) combined with rifampin (600-900 mg orally once daily) for a duration of 6 to 8 weeks. This combination is effective in reducing the risk of relapse and complications[3][4].

2. Alternative Regimens: In cases where doxycycline is contraindicated, alternatives such as:
   - Trimethoprim-sulfamethoxazole: This can be used in combination with rifampin.
   - Gentamicin: Often used in the initial phase of treatment, especially in severe cases, for a duration of 7 to 14 days[5].

3. Prolonged Therapy: For patients with complications such as osteoarticular involvement or endocarditis, prolonged therapy (up to 12 months) may be necessary, often involving a combination of antibiotics[6].

Supportive Care

In addition to antibiotic therapy, supportive care is essential. This may include:

• Hydration: Ensuring adequate fluid intake to prevent dehydration.
• Symptomatic Treatment: Management of fever and pain with antipyretics and analgesics.
• Monitoring: Regular follow-up to monitor for potential complications and response to treatment.

Considerations for Special Populations

• Pregnant Women: Treatment in pregnant women requires careful consideration due to potential risks to the fetus. Alternatives such as azithromycin may be considered, but the choice of antibiotics should be made with caution[7].
• Immunocompromised Patients: These patients may require more aggressive treatment and longer durations of therapy due to the increased risk of severe disease and complications[8].

Conclusion

The treatment of brucellosis due to Brucella suis primarily involves a combination of antibiotics, with doxycycline and rifampin being the most commonly used regimen. Supportive care plays a vital role in the overall management of the disease. Given the potential for complications, especially in certain populations, it is crucial for healthcare providers to tailor treatment plans based on individual patient needs and circumstances. Regular follow-up and monitoring are essential to ensure effective recovery and to mitigate the risk of relapse.

References

1. Brucellosis | 5-Minute Clinical Consult.
2. Brucellosis | 5-Minute Clinical Consult.
3. ICD-10 International Statistical Classification of Diseases.
4. Zoonoses - PMC.
5. Guidebook on Brucellosis.
6. ICD-10, International Statistical Classification of Diseases.
7. Brucellosis | 5-Minute Clinical Consult.
8. Zoonoses - PMC.