Evaluation of childhood brucellosis in the central Black Sea region

Abstract

Brucellosis is a systemic infectious disease that leads to various clinical pictures and is still a significant health problem in Turkey. In this study, 52 pediatric patients diagnosed with brucellosis between January 2008 and December 2013 were examined. Clinical and laboratory findings, response to treatment, prognosis and complications were evaluated. Diagnosis of brucellosis was made based on a clinical picture compatible with the disease, together with standard tube agglutination test (SAT) positivity (1/160 or higer titer) or isolation of Brucella spp. in a sterile body fluid culture. The cases comprised 10 females and 42 males. In 75% of cases, there was a history of consumption of unpasteurized milk or dairy products. The most commonly seen symptoms and findings were fever (75%), arthralgia (54%), fatigue (19%), splenomegaly (44%), hepatomegaly (42%) and arthritis (19%). Atypical presentations were seen in one case of epidydymo-orchitis and three cases of bleeding of the nose and gums. In the laboratory examinations, anemia was determined in 56% of cases, leukopenia in 40% and thrombocytopenia in 27%. In blood cultures taken from 41 patients, Brucella spp. were isolated in 23 (56.1%). All patients recovered, and sequelae were seen only in a patient with osteoarthritis. In conclusion, although brucellosis leads to many different clinical pictures, a very good response to treatment can be obtained. If effective treatment cannot be implemented in time, the disease may become chronic, and complications and relapses may be encountered. Therefore, early diagnosis and treatment is of great importance.