Brucellosis

Brucellosis (also known as Malta fever and undulant fever) is a great mimic and is usually a cryptic or masked infection. It can certainly reproduce the profound fatigue of myalgic encephalomyelitis (ME) and maladaptation syndrome and has to be considered as part of the differential diagnosis of any patient with chronic fatigue or multiple allergic-type symptoms.

Pasteurizing milk kills Brucella. Infections come from drinking raw milk from infected animals. Brucella produces a toxin which is responsible for widespread symptoms. The name undulant fever comes from the fact that the patient tends to have a relapsing illness, with a temperature that roller-coasters up and down.

Chronic brucellosis is characterized by fatigue, myalgia (muscle pain) and depression which may persist for weeks or months. This is very like ME, post viral fatigue syndrome, fibromyalgia and CFIDs. The onset is often insidious, with a general feeling of being unwell, headache, weakness, night sweats and muscle pains, usually ascribed to flu. Lymph modes are usually swollen and painful and the liver and spleen may be enlarged. Arthritis, spondylitis (spinal inflammation), bursitis, osteomyelitis, orchitis (testicular inflammation), epididymitis, meningitis and endocarditic have all been described in association with brucellosis.

The organism can be identified from blood samples, although this can be difficult. It is usually treated with tetracycline.

Research suggests that in recent years most cases of brucellosis come from occupational exposure and direct contact with animals rather than by consuming infected milk.