<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2183-8453</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Saúde Ocupacional online]]></journal-title>
<abbrev-journal-title><![CDATA[RPSO]]></abbrev-journal-title>
<issn>2183-8453</issn>
<publisher>
<publisher-name><![CDATA[Ajeogene Serviços Médicos Lda]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2183-84532022000200702</article-id>
<article-id pub-id-type="doi">10.31252/rpso.10.12.2022</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[BRUCELOSE - A PROPÓSITO DE UM CASO CLÍNICO]]></article-title>
<article-title xml:lang="en"><![CDATA[BRUCELLOSIS - CASE REPORT]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Durães]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sílvia]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carrapatoso]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ribeiro]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidade do Porto Faculdade de Medicina ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Faculdade de Medicina do Porto  ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,USF Lagoa  ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,USF Nova Lousada  ]]></institution>
<addr-line><![CDATA[Vale do Sousa Norte ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>12</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>12</month>
<year>2022</year>
</pub-date>
<volume>14</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2183-84532022000200702&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2183-84532022000200702&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2183-84532022000200702&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Introdução: A Brucelose é uma zoonose provocada por bactérias cocobacilos gram-negativos pertencentes ao género Brucella, que pode ser transmitida pelo contacto direto com animais ou com as suas secreções. É uma doença sistémica, com início agudo ou subagudo, geralmente duas a quatro semanas após a inoculação. A sua sintomatologia é inespecífica, mas apresenta-se tipicamente através de febre, suores noturnos, artralgias ou astenia. Apesar de ser uma doença endémica em muitos países subdesenvolvidos, continua subdiagnosticada e sub-reportada.  Descrição do caso: Trata-se de um indivíduo do sexo masculino, auxiliar de veterinário, de 28 anos e com contacto próximo e frequente com gado bovino, ovino e caprino. Desconhece ter alguma vez realizado exame de aptidão para o trabalho e refere utilizar como equipamento de proteção individual apenas luvas e avental de borracha, dependendo da atividade. Recorre ao serviço de urgência por dor testicular recorrente e por sintomas constitucionais. Analiticamente mostrou IgG para brucelose borderline. Assim, o caso foi notificado no Sistema Nacional de Vigilância Epidemiológica. O utente foi medicado com doxiciclina e rifampicina e posteriormente submetido a excisão do testículo direito, onde a peça cirúrgica testou positivo para Brucella spp., confirmando-se o diagnóstico de brucelose com orquiepididimite.  Discussão: Uma vez que o quadro de brucelose é inespecífico, uma história clínica detalhada com exploração do contexto laboral, é fundamental para o seu diagnóstico. Assim, é fundamental a formação e alerta dos profissionais de saúde para esta doença. A incidência de casos associados à exposição ocupacional é relevante, sendo os veterinários de animais de grande porte (e seus ajudantes) um dos grupos profissionais de maior risco. A baixa adesão ao equipamento de proteção individual e a falta de conhecimentos poderão ser fatores de perpetuação da infeção. É essencial facilitar o acesso aos serviços de Saúde Ocupacional para garantir a vigilância destes trabalhadores.  Conclusão: A brucelose é uma das doenças zoonóticas globalmente negligenciada, mantendo-se, contudo, como uma das três mais comuns em Portugal. Este caso é pertinente como forma de alerta aos profissionais de saúde para as patologias menos frequentemente relacionadas com a atividade laboral, nomeadamente as zoonoses, por esse motivo frequentemente subdiagnosticadas. A avaliação do risco profissional e implementação de medidas de proteção são fundamentais na diminuição do risco ocupacional, sendo necessária a avaliação das condições de trabalho por um técnico de segurança qualificado. Assim, as equipas de Saúde Ocupacional têm um papel preponderante na prevenção de doenças profissionais, promoção da saúde, implementação de medidas preventivas e diminuição da sua morbimortalidade.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: Brucellosis is a zoonosis caused by a gram-negative coccobacillus bacterium of the genus Brucella, which can be transmitted by direct contact with animals or their secretions. Is an acute or subacute systemic disease that generally starts two to four weeks after inoculation. Its symptoms are nonspecific, but typically are presented with fever, night sweats, arthralgias or asthenia. Although being endemic in underdeveloped countries, is still an underdiagnosed and underreported disease.  Case Report: This is a 28 year old veterinarian assistant male, with close and frequent contact with cattle, sheep and goats. He is unaware of having ever been submitted to an aptitude test for work and, as personal protective equipment, uses gloves and a rubber apron only. He was observed in the hospital emergency department, due to recurrent testicular pain and constitutional symptoms. Serology test showed a borderline IgG for brucellosis. Therefore, the case was notified in the National System of Epidemiological Vigilance. The patient was treated with doxycycline and rifampicin, and the testicle was surgically removed. The surgical piece accused Brucella spp, which confirmed the diagnosis of brucellosis with orchiepididymitis.  Discussion: Considering that the symptoms of brucellosis are unspecific, a detailed clinical history, including occupational exposure/background, is fundamental for the diagnosis. The incidence of cases associated with occupational exposure is relevant, being veterinarians and large animal veterinary assistants among the professional groups with higher risk. Low adherence to personal protective equipment and lack of knowledge may be factors that perpetuate the infection. It is essential to facilitate access to Occupational Health services to ensure the health surveillance of these workers.  Conclusion: Brucellosis is one of the most neglected zoonosis worldwide, however, it&#8217;s one of the three most common in Portugal. This case report urges the healthcare professionals to acknowledge these less known work-related diseases, in particular zoonosis, that are often underdiagnosed. The professional risk assessment and the implementation of protective measures are fundamental in reducing occupational risk, being the assessment of working conditions by a qualified safety technician required. Thus, Occupational Health teams play a leading role in preventing professional illnesses, promoting health, implementing preventive measures and reducing morbidity and mortality.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Saúde Ocupacional]]></kwd>
<kwd lng="pt"><![CDATA[Medicina do Trabalho]]></kwd>
<kwd lng="pt"><![CDATA[Segurança no Trabalho]]></kwd>
<kwd lng="pt"><![CDATA[Brucelose]]></kwd>
<kwd lng="pt"><![CDATA[Veterinário]]></kwd>
<kwd lng="en"><![CDATA[Occupational Health]]></kwd>
<kwd lng="en"><![CDATA[Work Medicine]]></kwd>
<kwd lng="en"><![CDATA[Work Security]]></kwd>
<kwd lng="en"><![CDATA[Brucellosis]]></kwd>
<kwd lng="en"><![CDATA[Veterinary]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pappas]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Akritidis]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Bosilkovski]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tsianos]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Brucellosis]]></article-title>
<source><![CDATA[The New England Journal of Medicine]]></source>
<year>2005</year>
<volume>352</volume>
<numero>22</numero>
<issue>22</issue>
<page-range>2325-36</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Young]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Human brucellosis]]></article-title>
<source><![CDATA[Reviews of Infectious Diseases]]></source>
<year>1983</year>
<volume>5</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>821-42</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Franco]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mulder]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Gilman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Smits]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Human brucellosis]]></article-title>
<source><![CDATA[The Lancet]]></source>
<year>2007</year>
<volume>7</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>775-86</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mendes]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Sousa]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Moreira]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Rosa]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Marques]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Brucellosis: A rapid risk assessment by a regional outbreak team and its coordinated response with the Directorate-General for Food and Veterinary, North region of Portugal, 2019]]></article-title>
<source><![CDATA[Zoonoses Public Health]]></source>
<year>2020</year>
<volume>67</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>587-90</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="">
<collab>European Centre for Disease Prevention and Control</collab>
<source><![CDATA[Brucellosis - Annual epidemiological report for 2020]]></source>
<year>2022</year>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Young]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Brucellosis: current epidemiology, diagnosis and management]]></article-title>
<source><![CDATA[Current Clinical Topics in Infectious Diseases]]></source>
<year>1995</year>
<volume>15</volume>
<page-range>115-28</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bosilkovski]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Krteva]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Dimzova]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Vidinic]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Sopova]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Spasovska]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Human brucellosis in Macedonia - 10 years of clinical experience in endemic region]]></article-title>
<source><![CDATA[Croatian Medical Journal]]></source>
<year>2010</year>
<volume>51</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>327-36</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mantur]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Amarnath]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Shinde]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Review of clinical and laboratory features of human brucellosis]]></article-title>
<source><![CDATA[Indian Journal of Medical Microbiology]]></source>
<year>2007</year>
<volume>25</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>188-202</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="book">
<collab>Despacho n.º 1150/2021</collab>
<source><![CDATA[[Internet]]]></source>
<year>2021</year>
<page-range>137-90</page-range><publisher-loc><![CDATA[Lisboa ]]></publisher-loc>
<publisher-name><![CDATA[Diário da República]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Solera]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez-Alfaro]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Espinosa]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recognition and optimum treatment of brucellosis]]></article-title>
<source><![CDATA[Drugs]]></source>
<year>1997</year>
<volume>53</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>245-56</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Al-Tawfiq]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Therapeutic options for human brucellosis]]></article-title>
<source><![CDATA[Expert review of anti-infective therapy]]></source>
<year>2008</year>
<volume>6</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>109-20</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gwida]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Dahouk]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Melzer]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Rösler]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Neubauer]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Tomaso]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Brucellosis - regionally emerging zoonotic disease]]></article-title>
<source><![CDATA[Croatian Medical Journal]]></source>
<year>2010</year>
<volume>51</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>289-95</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Gregório]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Saúde Ocupacional aplicada aos profissionais associados a atividades Veterinárias (auxiliares, enfermeiros e médicos)]]></article-title>
<source><![CDATA[Revista Portuguesa de Saúde Ocupacional online]]></source>
<year>2016</year>
<volume>1</volume>
<page-range>S143-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
