Treatment

Tetanus patients should still be vaccinated, because having the disease does not give you immunity against it.

Spatula test:
Is a simple diagnostic bedside test that involves touching the oropharynx with a spatula or tongue depressor. In normal circumstances, it elicits a gag reflex, and the patient tries to expel the spatula (i.e., a negative test result). If tetanus is present, patients develop a reflex spasm of the masseters and bite the spatula (i.e., a positive test result).

It has high specificity & sensitivity for tetanus

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Brucella spp. is considered to be the most common zoonotic pathogen, and the most common laboratory-acquired pathogen.

The Brucella organism's predilection for organs rich in reticuloendothelial cells (spleen, liver, bone marrow, lymph nodes) and its intracellular location are responsible for the chronicity of the disease, which can last for months or even years.

Brucellosis is also a rare cause of hepatic granulomas

It should be suspected in patients with Relevant signs and symptoms (fever, malaise, night sweats, and arthralgia) in the setting of relevant epidemiologic exposure (consumption of unpasteurized dairy products, animal exposure in an endemic area, and/or occupational exposure).

In short, you need signs and symptoms + an epidemiological history.