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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.

A definitive diagnosis of brucellosis may be made via either of the following:
● Culture of the organism from blood, body fluids (urine, cerebrospinal fluid, synovial fluid, and pleural fluid), or tissue (such as bone marrow or liver biopsy). However, this method is time consuming and hazardous.
● A fourfold or greater rise in Brucella antibody titer between acute and convalescent phase serum specimens obtained ≥2 weeks apart.

The WHO clinical criteria for Dengue hemorrhagic fever is characterized by the following 4 clinical manifestations:

(1) high-grade continuous fever for 2 to 7 days.

(2) a hemorrhagic tendency, such as a positive tourniquet test, or clinical signs of bleeding (petechiae, purpura,...etc).

(3) laboratory criteria involve thrombocytopenia (platelet less than 100,000 cells/mm3)

(4) hemoconcentration (a hematocrit increase of more than 20% from baseline), or pleural effusion, as a sign of plasma leakage.

The phrase “quebranta huesos” or “that which breaks bones” dates to a Spanish description likely to be of dengue fever from 1771.

"تدگ بالعظم"

The clinical manifestations of infectious mononucleosis are:
• Fever
• Symmetrical lymphadenopathy (& pharyngitis)
• Hepatosplenomegaly
• Petechiae of the palate

Jean-Martin Charcot was a French doctor in the 19th century who studied many diseases, including decubitus ulcers (today known as pressure ulcers). He noticed that patients who developed eschar of the buttocks and sacrum died after some time. He named this lesion "decubitus ominous," which meant death was inevitable after developing this lesion.

Charcot, after seeing a pressure ulcer: