Kazak Esra, Akalın Halis, Yılmaz Emel, Heper Yasemin, Mıstık Reşit, Sınırtaş Melda, Özakın Cüneyt, Göral Güher, Helvacı Safiye
Infectious Diseases and Clinical Microbiology Department, Uludag University Medical School, Bursa, Turkey.
Medical Microbiology Department, Uludag University Medical School, Bursa, Turkey.
Singapore Med J. 2016 Nov;57(11):624-629. doi: 10.11622/smedj.2015163. Epub 2015 Nov 13.
Brucellosis is a public health problem that is prevalent in several developing countries.
The clinical and laboratory characteristics of 164 cases of brucellosis in Bursa, Turkey, were retrospectively evaluated.
The ages of the 164 patients ranged from 15-85 years. All of the patients underwent the Rose Bengal test and 163 (99.4%) patients tested positive. 122 (74.4%) patients were diagnosed with acute brucellosis, 31 (18.9%) with subacute brucellosis and 11 (6.7%) with chronic brucellosis. Focal involvement was found in 101 (61.6%) patients. Although patients with focal involvement had a higher white blood cell count (p = 0.002), those without focal involvement had higher aspartate transaminase and alanine transaminase values, and lower platelet values (p = 0.005, 0.007 and 0.039, respectively). Spondylodiscitis was observed on imaging in 58 (66.7%) of the 87 patients who presented with back pain. Among the 118 patients who were examined within the first month of treatment, 79 (66.9%) responded to treatment. The relapse rate was 11.6% among all 164 patients.
Brucellosis should be considered as a differential diagnosis among patients who present with fever, and joint or back pain. Focal involvement should be investigated in the presence of leucocytosis, and subacute or chronic forms of brucellosis. To identify cases of spondylodiscitis, radiography should be performed in patients who present with back pain.
布鲁氏菌病是一个在多个发展中国家普遍存在的公共卫生问题。
对土耳其布尔萨164例布鲁氏菌病患者的临床和实验室特征进行回顾性评估。
164例患者年龄在15至85岁之间。所有患者均接受了玫瑰红试验，163例（99.4%）检测呈阳性。122例（74.4%）患者被诊断为急性布鲁氏菌病，31例（18.9%）为亚急性布鲁氏菌病，11例（6.7%）为慢性布鲁氏菌病。101例（61.6%）患者出现局灶性受累。虽然有局灶性受累的患者白细胞计数较高（p = 0.002），但无局灶性受累的患者天冬氨酸转氨酶和丙氨酸转氨酶值较高，血小板值较低（分别为p = 0.005、0.007和0.039）。在87例出现背痛的患者中，58例（66.7%）影像学检查发现脊椎间盘炎。在治疗第一个月内接受检查的118例患者中，79例（66.9%）对治疗有反应。164例患者的复发率为11.6%。
对于出现发热、关节或背痛的患者，应将布鲁氏菌病作为鉴别诊断之一。在存在白细胞增多以及亚急性或慢性布鲁氏菌病形式的情况下，应调查是否存在局灶性受累。对于出现背痛患者，应进行影像学检查以确定脊椎间盘炎病例。
