Implications of laboratory diagnosis on brucellosis therapy

Figures & data

Figure 1. Decision tree in the laboratory diagnosis of human brucellosis.

^†Cutoff values may vary in different populations and in patients depending on the stage of disease.

CT: Coombs’ test; RBT: Rose Bengal test; SAT: Serum agglutination test.

Table 1. Diagnostic yield of culture techniques, serologic tests and molecular methods in the laboratory diagnosis of human brucellosis depending on the stage of disease.

Diagnostic methods (n)	Diagnostic yield depending on the stage of disease (duration of clinical symptoms) (%)				Ref.
	Acute brucellosis (≤8 weeks)	Subacute brucellosis (8–52 weeks)	Chronic brucellosis (≥52 weeks)	Relapse
Whole blood culture
Brucella broth and subcultures (50)	66.6	23.5	0.0		[106]
Castañeda biphasic medium (88)	42.3	41.7	11.0	8.3	[35]
Castañeda biphasic medium (103)	54.7	36.4	28.6		[38]
Castañeda biphasic medium (148)	71.8		33.3		[42]
Castañeda biphasic medium (50)	83.3	40.0	25.0		[37]
Lysis centrifugation (88)	48.1	58.3	22.2	16.6	[35]
Lysis centrifugation (148)	90.9		74.1		[42]
Bone marrow culture
Brucella broth and subcultures (50)	83.3	52.0	33.0		[106]
Castañeda biphasic medium (50)	97.2	90.0	50.0		[37]
Castañeda biphasic medium (103)	92.2	72.7	64.3		[38]
Serology
Tube agglutination (50)	91.7	70.0	75.0		[37]
Serum agglutination (92)	21.0	50.0	27.5		[67]
Commercial IgM- and IgG-ELISA (92)	49.1	66.6	82,7		[67]
Molecular detection
Real-time quantitative PCR (18)	100			100	[95]

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