A farmer presenting with fever off-and on for the past 4 years was diagnosed to be suffering from chronic brucellosis. All of the following serological tests would be helpful in the diagnosis at this state except –
**Question:** A farmer presenting with fever off-and-on for the past 4 years was diagnosed to be suffering from chronic brucellosis. All of the following serological tests would be helpful in the diagnosis at this state except -
A. Brucella agglutination test (BAT)
B. Enzyme-linked immunosorbent assay (ELISA)
C. Complement fixation test (CFT)
D. Coombs' test
**Correct Answer:** **D. Coombs' test**
**Core Concept:**
Brucellosis is a zoonotic disease caused by bacteria from the Brucella species, primarily affecting animals but can also affect humans. The disease is characterized by prolonged fevers, fatigue, and joint pain. In the context of the question, we are discussing chronic brucellosis, which is present for more than 6 weeks. Serological tests play a crucial role in diagnosing brucellosis, as it is a non-specific disease that can mimic other conditions like tuberculosis and leprosy.
**Why the Correct Answer is Right:**
Coombs' test is a blood test that detects autoantibodies against red blood cells (RBCs). It is primarily used in diagnosing hemolytic anemia and is not specific to brucellosis. In the context of brucellosis diagnosis, Coombs' test is not suitable due to its limited sensitivity and specificity for brucellosis.
**Why Each Wrong Option is Incorrect:**
A. **Brucella agglutination test (BAT):** BAT detects agglutination of Brucella bacteria in the blood. It is a simple, rapid, and inexpensive test and is widely used in diagnosing brucellosis. However, it has a lower specificity compared to other tests like ELISA or CFT, which makes it less reliable in chronic brucellosis cases.
B. **Enzyme-linked immunosorbent assay (ELISA):** ELISA is a laboratory test that detects the presence of specific antibodies in the patient's blood. It is a highly sensitive and specific test for diagnosing brucellosis, making it an appropriate choice for chronic brucellosis.
C. **Complement fixation test (CFT):** CFT measures the formation of complement complexes in response to Brucella antigens. It is a widely used and reliable serological test for brucellosis diagnosis, particularly in chronic cases.
**Clinical Pearl:** In chronic brucellosis, serological tests are crucial for diagnosis. ELISA, CFT, and BAT are widely used tests with varying sensitivities and specificities. Coombs' test is not specific to brucellosis and hence is not the best choice for diagnosing chronic brucellosis.