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布鲁氏菌病的临床表现、并发症及治疗:72 例病例评估。

Clinical manifestations, complications, and treatment of brucellosis: evaluation of 72 cases.

出版信息

Turk J Med Sci. 2014;44(2):220-3. doi: 10.3906/sag-1112-34.

Abstract

AIM

Brucellosis is an important disease in developing countries. We aimed to determine the epidemiologic, clinical, and laboratory characteristics of brucellosis, which still has a high morbidity in Turkey.

MATERIALS AND METHODS

Seventy-two patients with brucellosis, monitored at our clinic from January 2004 to July 2010, were reviewed retrospectively.

RESULTS

The average age was determined to be 44.8 ± 18 years, and 40 of the patients were female (55.6%). The most frequent transmission route was the use of raw milk and dairy products, in 45 of the patients (62.5%). The most frequent complaints were joint pain, high fever, weakness, low back pain, and gastrointestinal symptoms, whereas the most frequent physical examination findings were fever, osteoarticular involvement, splenomegaly, hepatomegaly, and lymphadenopathy. All of the patients were positive for Rose Bengal testing. The standard tube agglutination titer was 1/160 or higher in 64 (88.9%) patients. Brucella melitensis was isolated from blood cultures of 13 (18.1%) patients and bone marrow cultures of 7 (9.7%) patients. Complications of sacroiliitis in 6 (8.3%), spondylodiscitis in 4 (5.6%), endocarditis in 2 (2.8%), neurobrucellosis in 1 (1.4%), and epididymo-orchitis in 1 (1.4%) of the patients were observed.

CONCLUSION

Brucellosis has various clinical presentations. It should be included in the differential diagnosis of high fever and joint pains in endemic countries.

摘要

目的

布氏杆菌病是发展中国家的一种重要疾病。我们旨在确定布氏杆菌病的流行病学、临床和实验室特征,该病在土耳其仍有较高的发病率。

材料和方法

回顾性分析 2004 年 1 月至 2010 年 7 月在我院监测的 72 例布氏杆菌病患者。

结果

平均年龄为 44.8 ± 18 岁,40 例为女性(55.6%)。最常见的传播途径是食用生牛奶和奶制品,45 例(62.5%)。最常见的症状是关节疼痛、高热、乏力、腰痛和胃肠道症状,而最常见的体格检查发现是发热、骨关节受累、脾肿大、肝肿大和淋巴结肿大。所有患者均对孟加拉玫瑰红试验呈阳性。64 例(88.9%)患者标准试管凝集试验滴度为 1/160 或更高。13 例(18.1%)患者血液培养和 7 例(9.7%)患者骨髓培养分离出布鲁氏菌。6 例(8.3%)患者并发骶髂关节炎,4 例(5.6%)患者并发脊椎炎,2 例(2.8%)患者并发心内膜炎,1 例(1.4%)患者并发神经布氏杆菌病,1 例(1.4%)患者并发附睾睾丸炎。

结论

布氏杆菌病有多种临床表现。在流行地区,高热和关节痛应考虑该病的鉴别诊断。

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