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布鲁氏菌病疑似病例是诊断的最重要标准,尤其是在流行地区。

Brucellosis Suspicion is the Most Important Criterion for Diagnosis Particularly in Endemic Regions.

作者信息

Yilmaz Baris, Ozdemir Guzelali, Aktas Erdem, Komur Baran, Alfidan Serdar, Memisoglu Serdar, Duymuş Tahir Mutlu

机构信息

Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

Dr. A. Yurtaslan Ankara Onkology Training and Research Hospital, Ankara, Turkey.

出版信息

Open Orthop J. 2016 Feb 29;10:7-11. doi: 10.2174/1874325001610010007. eCollection 2016.

Abstract

INTRODUCTION

Brucellosis is a zoonotic infectious disease that remains endemic in developing countries. The purpose of this study is to emphasize the need for considering brucellosis as a diagnosis, since this disease has a high risk of complications among young patients when not treated appropriately.

METHODOLOGY

A total of 88 brucellosis cases with blood cultures that were positive for the pathogen were evaluated retrospectively in this study.

RESULTS

The patients included 33 males (37.5%) and 55 females (62.5%) with a median age of 8.9 years (range: 5-14 years). A total of 43.1% (n=38) of the cases included occupational exposure to animals as a possible infection source. The consumption of raw milk products, especially cheese, was present in 52.2% (n=46) of the cases. Clinically, 55 of the cases were acute (62.5%), 23 of the cases were subacute (26.2%) and 10 of the cases were chronic (11.3%). The distribution of the joint pain complaints was as follows: 62.5% (n=55) of patients reported hip pain, 22.7% (n=20) of patients reported knee pain, 11.4% (n=10) of patients reported lumbar-back pain and 3.4% (n=3) of patients reported pain in other joints. A total of 59.1% (n=52) of the cases had been examined by another doctor at least once and mistreated.

CONCLUSION

Complication rates and the rate of chronic infection increase with delayed diagnosis, and clinical doubt is the most important criterion for diagnosis, particularly in endemic regions.

摘要

引言

布鲁氏菌病是一种人畜共患传染病,在发展中国家仍然流行。本研究的目的是强调将布鲁氏菌病纳入诊断的必要性,因为这种疾病在年轻患者中若未得到适当治疗会有很高的并发症风险。

方法

本研究对88例血培养病原体呈阳性的布鲁氏菌病病例进行了回顾性评估。

结果

患者包括33名男性(37.5%)和55名女性(62.5%),中位年龄为8.9岁(范围:5 - 14岁)。共有43.1%(n = 38)的病例职业接触动物为可能的感染源。52.2%(n = 46)的病例有食用生奶制品,尤其是奶酪的情况。临床上,55例为急性(62.5%),23例为亚急性(26.2%),10例为慢性(11.3%)。关节疼痛主诉的分布如下:62.5%(n = 55)的患者报告髋关节疼痛,22.7%(n = 20)的患者报告膝关节疼痛,11.4%(n = 10)的患者报告腰背痛,3.4%(n = 3)的患者报告其他关节疼痛。共有59.1%(n = 52)的病例至少被另一位医生检查过一次且治疗不当。

结论

随着诊断延迟,并发症发生率和慢性感染率会增加,临床怀疑是诊断的最重要标准,特别是在流行地区。

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