THE IMPORTANCE OF INFLAMMATION MARKERS IN BRUCELLOSIS: DIAGNOSTIC, PROGNOSTIC, MONITORING, DIFFERENTIAL DIAGNOSIS, AND TREATMENT CONSIDERATIONS
Abstract
Resume. Brucellosis is a widespread zoonotic infection caused by Brucella species, frequently complicated by osteoarticular involvement (10–85% of cases). Inflammation plays a central role in its pathogenesis due to intracellular persistence of the pathogen in macrophages. Traditional inflammatory markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell count, and derived ratios (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune-inflammation index [SII]) serve as accessible, cost-effective tools for diagnosis, severity assessment, prediction of complications, differential diagnosis, and treatment monitoring, particularly in endemic regions. These markers help distinguish brucellosis from mimics like typhoid, tuberculosis, and viral fevers. They also guide prolonged antibiotic therapy (e.g., doxycycline + rifampin) and early detection of relapse. This review highlights the multifaceted value of inflammation markers in improving outcomes in resource-limited settings. Keywords: Brucellosis; inflammation markers; C-reactive protein (CRP); erythrocyte sedimentation rate (ESR); neutrophil-to-lymphocyte ratio (NLR); osteoarticular involvement; differential diagnosis; treatment monitoring