When should I consider referring a patient with suspected brucellosis to a specialist for further evaluation and management?

Consider referring a patient with suspected brucellosis to a specialist for further evaluation and management when:

• There is diagnostic uncertainty or the patient has complex clinical features that require specialist input.
• The patient is unable to take oral antibiotics or has pre-existing medical conditions that increase risk, necessitating expert advice or management.
• There are systemic symptoms or complications suggesting severe or disseminated infection that may require hospital assessment.
• Specialist microbiological or infectious disease expertise is needed for confirmation of diagnosis, treatment planning, or management of complications.

In the absence of specific UK guidelines on brucellosis referral, clinical judgement should guide the timing and urgency of referral, similar to other complex zoonotic infections where specialist advice is recommended for patients at risk or with complicated presentations.