Solera Javier, Solís García Del Pozo Julián
a Servicio de Medicina Interna , Complejo Hospitalario Universitario de Albacete , Albacete , Spain.
b Departamento de Ciencias Médicas, Facultad de Medicina de Albacete , Universidad de Castilla-La Mancha , Albacete , Spain.
Expert Rev Anti Infect Ther. 2017 Jan;15(1):33-42. doi: 10.1080/14787210.2017.1254042. Epub 2016 Nov 10.
Pulmonary involvement is a rare, focal complication of human brucellosis. The aim of this review is to describe clinical and radiologic features, treatment administered and clinical course of these patients. Areas covered: We conducted a systematic search of scientific reports of brucellosis with pulmonary involvement published from January 1985 to July 2016. Four main patterns of disease were observed: pneumonia, pleural effusion, nodules and interstitial pattern. Cough and fever were the most common symptoms. Brucella spp. culture was obtained from blood (50%) or pleural fluid. Treatment is based on the same antibiotics and combinations of antibiotics as for patients with acute no complicated brucellosis. The most frequent antimicrobial combination was doxycycline and rifampin for six weeks. The clinical course was favorable in most reports, and mortality was remarkably low (<1%). Expert commentary: Non-specific clinical and radiological manifestations were the main reason for the delay in proper treatment. Difficulty in distinguishing Brucellosis from other pulmonary infections, such as tuberculosis, sometimes posed an added diagnostic challenge.
肺部受累是人类布鲁氏菌病罕见的局灶性并发症。本综述的目的是描述这些患者的临床和放射学特征、所接受的治疗及临床病程。涵盖领域：我们对1985年1月至2016年7月发表的有关布鲁氏菌病肺部受累的科学报告进行了系统检索。观察到四种主要疾病模式：肺炎、胸腔积液、结节和间质模式。咳嗽和发热是最常见的症状。布鲁氏菌属培养物取自血液（50%）或胸腔积液。治疗基于与急性无并发症布鲁氏菌病患者相同的抗生素及抗生素组合。最常用的抗菌组合是多西环素和利福平，疗程六周。在大多数报告中临床病程良好，死亡率极低（<1%）。专家评论：非特异性临床和放射学表现是延误恰当治疗的主要原因。难以将布鲁氏菌病与其他肺部感染（如结核病）区分开来，有时会带来额外的诊断挑战。
