Prognosis
Brucellosis is rarely a fatal disease. Mortality varies from 1% to 5%, and the majority of these patients had developed infective endocarditis as a consequence of infection. Therefore, early diagnosis and intervention are essential.[41][42] Short-term and long-term follow-up is essential for endocarditis patients, particularly those aged 18 to 39 years, in the first 6 months after treatment.
Response to treatment
Symptoms can resolve 3 to 11 days after starting treatment in uncomplicated disease, and the response is generally favourable. Relapse can occur in approximately 10% of patients.[6] Short durations of antibiotic treatment are associated with relapse or treatment failure. Most relapses tend to occur 3 to 6 months after treatment completion. The antibiotic regimen used may be an associated factor, with doxycycline and rifampicin having a slightly higher relapse rate than doxycycline and an injectable aminoglycoside (10% vs. 5% to 10%).[127]
Antibody titres may not decrease in the first few months of treatment. IgG titres can take up to 18 months to become undetectable.[1] IgM titres tend to remain positive even after the patient has been treated but usually reduce to lower titres over time.
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