What are the key clinical features and symptoms of brucellosis that I should look for in patients with potential exposure?

Key clinical features and symptoms of brucellosis to identify in patients with potential exposure include:

• Fever, often undulant or intermittent, is the most common presenting symptom.
• Profound malaise, fatigue, and sweats, particularly night sweats, are frequently reported.
• Musculoskeletal symptoms such as arthralgia, myalgia, and back pain are common and may indicate osteoarticular involvement.
• Headache and anorexia may also be present.
• Other systemic features can include weight loss, hepatosplenomegaly, and lymphadenopathy.
• Chronic or relapsing symptoms may occur if untreated, with potential complications involving the liver, heart (endocarditis), and central nervous system.

These symptoms typically develop after exposure to infected animals or animal products, such as unpasteurised dairy, and should prompt consideration of brucellosis in the differential diagnosis, especially in endemic areas or occupational risk groups NICE CKS Mantur et al. 2007.