Colmenero et al listed criteria for relapse in a patient with brucellosis. The authors are from Carlos Haya University Hospital in Malaga, Spain.
Assessment: after completion of antibiotic therapy
Criteria for relapse - one or more of the following:
(1) new positive blood culture (any positive culture would do)
(2) reappearance of symptoms AND increase in an inflammatory marker AND persisting or increasing serologic titers
(3) lesion reappearing or increasing in size on imaging studies AND increase in an inflammatory marker AND persisting or increasing serologic titers
where:
• Inflammatory marker = C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR).
• Serologic tests tend to show significant variation between runs. If tracking serologic titers it is good to retest any previous serum sample at the same time as a new sample. Any change is more likely to reflect a real change rather than run-to-run variation.
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