Majid Avijgan MD Professor of Infectious and Tropical

ﺑﺴﻢ ﺍﻟﻠﻪ ﺍﻟﺮﺣﻤﻦ ﺍﻟﺮﺣیﻢ Majid Avijgan MD, Professor of Infectious and Tropical diseases, Isfahan University of Medical Sciences, Oct 2010, Aban 1389

Majid Avijgan MD. Professor of Infectious Diseases Isfahan University of Medical Sciences Sanaz Sarikhani MD .

Brucellosis serology

Serologic Tests: 1) Rose Bengal Plate Test (RBPT): آﺰﻣﺎیﺸگﺎﻩ ﺍﺑﺘﺪﺍ ﺍیﻦ ﺗﺴﺖ ﺭﺍ ﺍﻧﺠﺎﻡ ﻣیﺪﻫﺪ ﻭ ﺩﺭ ﺻﻮﺭﺗی کﻪ « ﺗﻮﺳﻂ پﺰﺷک ﺩﺭﺧﻮﺍﺳﺖ ﺷﺪﻩ ﺑﺎﺷﺪ ﺑﻪ ﺻﻮﺭﺕ» ﻣﺜﺒﺖ « ﻭ» ﻣﻨﻔی . گﺰﺍﺭﺵ ﻣیﺸﻮﺩ n is a rapid screening method; however, positive sera should always be confirmed by SAT. 2) Serum Agglutination Test (SAT) (Wright’s): n Detects Ig. M, Ig. G, Ig. A. 3) 2 -mercaptoethanol test (2 ME) : n Detects Ig. G, Ig. A. 5

Serologic Test: 4) Coomb’s test: n Detects Ig. G (monomers & dimmer), Ig. M, Ig. A. 5) CF 6) RIA 7) ELISA: Ig. M, Ig. G, Ig. A , Or Total Antibody

Serologic Test Approach: n Step 1 - what is the main Ig? n Step 2 - where is this test? n Step 3 - What is your diagnosis?

Case Number 1 Wright's < 1/40 2 ME negative 8

Case Number 1 n Early Acute disease:

Case Number 2 Wright's ≥ 1/160 2 ME ≤ W/2 0 r 1/80

Case Nnmber 2 n Acute disease:

Case Number 3 Wright’s < or > 1/80 2 ME negative

Case Number 3 n Subclinical infection:

Case Number 4 n Chronic disease (> 1 year):

Case Number 5 n Relapsed Chronic disease:

Brucellosis serology Wright 1/160 2 ME 1/80 --- Ig. G > Ig. M ---Acute Infection , Early Infection

Brucellosis serology n Wright > 1/80 n 2 ME = 0 n Ig. M predominant n Early (1 -2 weeks) Infection n End (2 years) of Infection

Brucellosis serology n Wright >1/640 n 2 ME =0 n Ig. M continious stimulation n Subclinical Infection

Brucellosis serology n Wright = 2 ME = 1/80 n Chronic Infection

Brucellosis serology n Wright = 2 ME = 1/80 n Wright >1/160, 2 ME >1/80 n Relaps of Infection (Chronic infection)

Brucellosis Diagnosis n 1 -Epidemiological evidance n 2 -Cilinical manifestations n 3 -Laboratory data

Brucellosis Treatment

Brucellosis