Abstract

Objective: We aimed to contribute to the literature by presenting the epidemiologic, clinical, and laboratory characteristics of pediatric patients with brucellosis followed up by our clinic.

Method: The medical records of patients aged 0-18 years who were followed up with a diagnosis of brucellosis in Gazi University Pediatric Infectious Diseases Clinic between 2010-2020 were retrospectively analyzed. The effect of demographic, clinical, and laboratory markers on diagnosis was investigated.

Results: The mean age was 162.0 ± 55.5 months. Of the 47 patients included in our study, 68% lived in rural areas. While 82.5% had a background of consuming raw milk and dairy products, 55% had experience in animal husbandry. Twenty-two patients had a family history of brucellosis. The most common symptoms were joint pain in 85%, malaise in 78%, and muscle pain in 42%. The most common associated findings were fever in 59%, joint stiffness in 23%, and splenomegaly in 17%. The decrease in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values and the increases in leukocytes, hemoglobin, and platelets before and after treatment were statistically significant (p<0.001). Anemia was the most common in the patients, followed by neutropenia, thrombocytopenia, thrombocytosis, leukocytosis, and pancytopenia, respectively. Blood culture positivity was 12%. Of 47 patients with positive tube agglutination titer, Rose Bengal was positive in 80% and negative in 19%.

Conclusion: Brucellosis remains an important public health problem in Türkiye. Patients should be questioned in detail in the presence of fever, arthralgia, hepatosplenomegaly, and pancytopenia which presents with different clinical findings. Rose Bengal negativity, which is used as a screening test, should not mislead us in making a diagnosis in the presence of clinical suspicion. Tube agglutination tests should definitely be performed in patients with suspected brucellosis. In addition, changes in non-specific blood parameters such as CRP, ESR, leukocytes, hemoglobin, and platelets may be indicative for clinicians.

Keywords: Blood, brucellosis, childhood

Copyright and license

How to cite

1.
Güdeloğlu E, Tezer H, Polat M, Kara Ulu N, Atay Ünal N, Medeni V, et al. Pediatric brucellosis in the central mediterranean region of Türkiye: Insights from a single-center experience. Trends in Pediatrics. 2023;4(2):127-132. https://doi.org/10.59213/TP.2023.27928

References

  1. Bukhari EE. Pediatric brucellosis. An update review for the new millennium. Saudi Med J. 2018;39:336-41. https://doi.org/10.15537/smj.2018.4.21896
  2. UpToDate. Brucellosis: Epidemiology, microbiology, clinical manifestations, and diagnosis. Available at: https://www.uptodate.com/contents/brucellosis-epidemiology-microbiology-clinical-manifestations-and-diagnosis?source=history_widget (Accessed on April 12, 2023).
  3. Republic of Turkey Ministry of Health, General Directorate of Public Health, Department of Zoonotic and Vector Diseases. Brucellosis Statistics Data. Available at: https://hsgmdestek.saglik.gov.tr/tr/zoonotikvektorel-bruselloz/istatistik (Accessed on April 12, 2023).
  4. Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med. 2005;352:2325-36. https://doi.org/10.1056/NEJMra050570
  5. National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (US). Brucellosis reference guide: exposures, testing and prevention. Atlanta, Georgia; 2017.
  6. Downes KJ. Brucella. In: Robert M. Kliegman M, Joseph W. St Geme III M, Nathan J, Blum M et al., editors. Nelson Texbook of Pediatrics (21st ed). Philadelphia, Pennsylvania; 2020:6199-206.
  7. Tanir G, Tufekci SB, Tuygun N. Presentation, complications, and treatment outcome of brucellosis in Turkish children. Pediatr Int. 2009;51:114-9. https://doi.org/10.1111/j.1442-200X.2008.02661.x
  8. Bayhan Gİ, Batur A, Ece İ. Pulmonary infections due to brucellosis in childhood. Çocukluk çağında bruselloza bağlı akciğer infeksiyonları. Tuberk Toraks. 2020;68:43-7. https://doi.org/10.5578/tt.69015
  9. Yumuk Z, O'Callaghan D. Brucellosis in Turkey - an overview. Int J Infect Dis. 2012;16:e228-35. https://doi.org/10.1016/j.ijid.2011.12.011
  10. Helvacı M, Atila D, Barışık V. The retrospective evaluation of 57 cases with brucellosis in childhood. Journal of Tepecik Education and Research Hospital. 2011;21:135-8. https://doi.org/10.5222/terh.2011.09157
  11. Çelebi S, Hacımustafaoğlu M, Demirtaş F, Salı E, Gül Ü, Özel M. Brucellosis in Childhood. J Pediatr Inf. 2011;5:59-62. https://doi.org/10.5152/ced.2011.23
  12. Demirtürk N, Demirdal T, Erben N, et al. Brucellosis: a retrospective evaluation of 99 cases and review of brucellosis treatment. Trop Doct. 2008;38:59-62. https://doi.org/10.1258/td.2006.006266
  13. Kanık Yüksek S, Gülhan B. Brucellosis in childhood: a single center experience. Turkish J Pediatr Dis. 2019;13:435-41. https://doi.org/10.12956/tchd.506827
  14. Buzgan T, Karahocagil MK, Irmak H, et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis. 2010;14:e469-78. https://doi.org/10.1016/j.ijid.2009.06.031
  15. Gündeşlioğlu ÖÖ. Brucella infection in children: evaluation of 148 pediatric patients. J Clin Anal Med. 2019;10:99-103. https://doi.org/10.4328/JCAM.5956
  16. Pourakbari B, Abdolsalehi M, Mahmoudi S, Banar M, Masoumpour F, Mamishi S. Epidemiologic, clinical, and laboratory characteristics of childhood brucellosis : A study in an Iranian children's referral hospital. Wien Med Wochenschr. 2019;169:232-9. https://doi.org/10.1007/s10354-019-0685-z
  17. American Academy of Pediatrics. Brucellosis. In: Pickering LK, editor. Red Book 2021: Report of the Committee on Infectious Diseases (32th ed). Elk Grove Village, Illinois; 2021:237-9.
  18. Kaya O, Akçam FZ, Avşar K, Tığlı A, Yaylı G. Brucellosis: evaluation of clinical and laboratory findings of 75 cases. Turkiye Klinikleri J Med Sci. 2006;26:623-9.
  19. Solís García del Pozo J, Solera J. Systematic review and meta-analysis of randomized clinical trials in the treatment of human brucellosis. PLoS One. 2012;7:e32090. https://doi.org/10.1371/journal.pone.0032090
  20. Battikh H, Berriche A, Zayoud R, et al. Clinical and laboratory features of brucellosis in a university hospital in Tunisia. Infect Dis Now. 2021;51:547-51. https://doi.org/10.1016/j.idnow.2021.03.005