Diju Inayat Ullah
Department of Medicine, Abbottabad International Medical College, Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2009 Apr-Jun;21(2):128-31.
Muscular pains, arthralgias and arthritis are among the most common symptoms of the patients attending various OPDs and private clinics every day. While the symptoms could be due to a broad spectrum of the illnesses; the infection with Brucella, often overlooked, is one among such causes. The objective of present study is to determine the extent to which this infection contributes towards the presence of such symptoms, and how important it is to rule out this treatable cause in our society, before labelling and treating these as non-specific aches and pains.
This prospective study was conducted on 280 patients at a registered medical specialist clinic between May 2006 and June 2008. The patients of each gender from age 15 years onwards having the symptoms of chronic muscular pains, backache, and arthralgias etc. were included in the study. The exclusion criteria were clear cut bone and joint diseases, connective tissue and systemic disorders. The patients were subjected to evaluation by history taking that especially looked into their involvement with cattle look-after and also the use of milk and other dairy items. The investigations included agglutination test for Brucella. The positive cases were treated and the results followed for satisfactory or mild responses.
Out of 280 cases 55 (19.64%) were suffering from infection with Brucella. The above patients had received non-specific treatment with analgesics or even steroids with no benefit. The young females outnumbered males, and rural cases had more incidence than urban; and there was a slight increase in those cases who handled the cattle at home as compared to those who did not.
In absence of a good veterinary care of live stock in societies like that of Pakistan, it becomes important to rule out Brucellosis, before labelling the symptoms of a patient as simple, non specific aches and pains; and therefore depriving the patient of a treatable disease if he had one.
肌肉疼痛、关节痛和关节炎是每天前往各类门诊和私人诊所就诊患者最常见的症状。虽然这些症状可能由多种疾病引起，但布鲁氏菌感染往往被忽视，却是其中一个病因。本研究的目的是确定这种感染在导致此类症状方面的作用程度，以及在将这些症状视为非特异性疼痛并进行治疗之前，排除这种可治疗病因在我们社会中的重要性。
本前瞻性研究于2006年5月至2008年6月在一家注册的医学专科诊所对280名患者进行。研究纳入了15岁及以上有慢性肌肉疼痛、背痛和关节痛等症状的各性别患者。排除标准为明确的骨和关节疾病、结缔组织和系统性疾病。通过病史采集对患者进行评估，特别关注他们与牲畜照料的接触情况以及牛奶和其他乳制品的食用情况。检查包括布鲁氏菌凝集试验。对阳性病例进行治疗，并跟踪结果以观察是否有满意或轻微反应。
280例病例中，55例（19.64%）感染了布鲁氏菌。上述患者曾接受过镇痛药甚至类固醇的非特异性治疗，但无效果。年轻女性多于男性，农村病例的发病率高于城市；与未接触牲畜的患者相比，在家中接触牲畜的患者发病率略有增加。
在像巴基斯坦这样的社会中，由于缺乏良好的牲畜兽医护理，在将患者的症状标记为简单的非特异性疼痛之前，排除布鲁氏菌病变得很重要；否则，如果患者患有可治疗的疾病，就会使其得不到治疗。
