Gedalia A, Watemberg N, Rothschild M
Dept. of Pediatrics, Soroka Medical Center, Beer Sheba.
Harefuah. 1990 Nov 15;119(10):313-5.
33 children (22 girls) with brucellosis seen between 1972-1988 were studied retrospectively. All but 1 were Bedouins. The mean age at diagnosis was 9.8 years (range: 17 months-17 years). Duration of illness prior to diagnosis was less than 1 week in 13 (39%), 1-4 weeks in 8 (24%) and 1-3 months in 10 (30%). In 2 cases the symptoms lasted 6 and 8 months, respectively, before diagnosis. Presenting symptoms included fever (85%), articular involvement (65%), hepatomegaly (45%) and splenomegaly (33%). Less common manifestations were anorexia (30%) and weight loss (15%) cases. Meningoencephalitis developed in 2 patients and uveitis and glomerulonephritis in 1 each. Diagnosis was based on positive agglutination titers (greater than 160), which were found in all. Brucella melitensis was isolated in blood cultures in 8 of the 33. 18 were treated with tetracycline and 9 with tetracycline and streptomycin, all of whom responded well. 3 of the 6 treated with trimethoprimsulphamethoxazole were only cured when therapy was changed to tetracycline in 2 and tetracycline plus streptomycin in 1. All patients recovered without sequelae. We conclude that brucellosis due to Brucella melitensis is endemic among the Bedouin of the Negev. An increased incidence of brucellosis among hospitalized children has been noted in the past 2 years, indicating the need for diagnostic awareness.
对1972年至1988年间收治的33例布鲁氏菌病患儿（22例女孩）进行回顾性研究。除1例之外，其余均为贝都因人。确诊时的平均年龄为9.8岁（范围：17个月至17岁）。确诊前病程不足1周的有13例（39%），1至4周的有8例（24%），1至3个月的有10例（30%）。2例患儿在确诊前症状分别持续了6个月和8个月。主要症状包括发热（85%）、关节受累（65%）、肝肿大（45%）和脾肿大（33%）。较少见的表现为厌食（30%）和体重减轻（15%）。2例患者发生了脑膜脑炎，1例发生了葡萄膜炎，1例发生了肾小球肾炎。诊断依据为所有患者凝集效价均呈阳性（大于160）。33例中有8例血培养分离出羊种布鲁氏菌。18例接受四环素治疗，9例接受四环素加链霉素治疗，所有患者反应良好。6例接受复方新诺明治疗的患者中，2例改为四环素治疗、1例改为四环素加链霉素治疗后才治愈。所有患者均康复，无后遗症。我们得出结论，内盖夫地区贝都因人中羊种布鲁氏菌引起的布鲁氏菌病呈地方性流行。过去2年住院儿童布鲁氏菌病发病率有所上升，提示需要提高诊断意识。
