a Department of Infectious Diseases and Clinical Microbiology , Yıldırım Beyazıt University, Faculty of Medicine, Ankara Atatürk Education and Research Hospital , Ankara , Turkey ;
b Department of Infectious Diseases and Clinical Microbiology , Ankara Numune Education and Research Hospital , Ankara , Turkey ;
Infect Dis (Lond). 2016;48(3):215-21. doi: 10.3109/23744235.2015.1107187. Epub 2015 Nov 15.
This study aimed to find markers to predict complicated cases in brucellosis. Patients with and without complications were compared in terms of epidemiological, clinical and laboratory properties.
A total of 700 patients hospitalised at the Department of Infectious Diseases and Clinical Microbiology were evaluated retrospectively.
Of a total of 700 patients, 383 (54.7%) were male and mean age was 41.5 ± 17.0 years. Of the patients, 517 (73.8%) were classified as acute cases. Complications occurred significantly less frequently in acute infections (p < 0.001). Increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) occurred more frequently in patients with complicated cases (p = 0.005 and 0.021, respectively), whereas malaise, myalgia and blood culture positivity occurred significantly less frequently in those cases (p < 0.001, < 0.001 and 0.014, respectively). Fever at examination, loss of malaise and myalgia and blood culture negativity were statistically significant predictive factors for complicated patients in multivariate analysis (p < 0.001, for each). As compared to patients without orchitis, leukocytosis occurred more often in cases with orchitis (p < 0.001); leukopenia occurred more often in neurobrucellosis than in cases without neurobrucellosis (p = 0.008). Of patients who attended control regularly, 422 (98%) were treated successfully. All of the nine patients who did not recover fully were cases with osteoarticular involvement.
Fever was the most significant predictive marker of complications. Other classical symptoms of brucellosis like myalgia and malaise were absent in most of the complicated cases. Blood culture was of limited value in the diagnosis of complicated cases most of the time.
本研究旨在寻找预测布鲁氏菌病复杂病例的标志物。比较了有并发症和无并发症的患者在流行病学、临床和实验室特征方面的差异。
回顾性评估了感染病学和临床微生物学系的 700 名住院患者。
700 名患者中，383 名（54.7%）为男性，平均年龄为 41.5±17.0 岁。700 名患者中，517 名（73.8%）为急性感染。并发症在急性感染中发生率明显较低（p＜0.001）。复杂病例中 C 反应蛋白（CRP）和红细胞沉降率（ESR）升高更为常见（p=0.005 和 0.021），而不适、肌痛和血培养阳性在这些病例中发生率明显较低（p＜0.001、＜0.001 和 0.014）。检查时发热、不适和肌痛消失以及血培养阴性是多变量分析中复杂患者的统计学显著预测因素（p＜0.001，每项）。与无睾丸炎患者相比，睾丸炎患者白细胞增多更常见（p＜0.001）；神经型布鲁氏菌病患者白细胞减少更常见（p=0.008）。定期就诊的 422 名患者（98%）成功治愈。未能完全康复的 9 名患者均为骨关节炎受累病例。大多数情况下，血液培养对复杂病例的诊断价值有限。
发热是并发症的最显著预测标志物。大多数复杂病例中，布鲁氏菌病的其他典型症状如肌痛和不适都不存在。血液培养在大多数情况下对复杂病例的诊断价值有限。
