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16 例中国儿科布鲁氏菌病患者在非疫区出现发热,8 例出现骨关节受累。

Sixteen Chinese pediatric brucellosis patients onset of fever in non-epidemic areas and 8 developed with osteoarticular involvement.

机构信息

Department of Pediatric Rheumatology and Immunology, Children's Hospital affiliated to Capital Institute of Pediatrics, Yabao Road No 2, Chaoyang district, Beijing, 10020, China.

Department of Radiology, Children's Hospital affiliated to Capital Institute of Pediatrics, Yabao Road No 2, Chaoyang district, Beijing, 10020, China.

出版信息

Clin Rheumatol. 2018 Jan;37(1):145-149. doi: 10.1007/s10067-017-3819-y. Epub 2017 Sep 19.

Abstract

The purpose of this study is to summarize the manifestations, diagnosis, differential diagnosis, and treatment of childhood brucellosis in non-epidemic areas of China. A retrospective review of 16 admitted children patients with brucella's disease who were diagnosed of brucellosis during the period from 2011 to 2016 was performed. Diagnostic criteria, clinical presentations, and outcomes were recorded. The most common symptom was fever. Osteoarticular involvement was found in 50% of the patients. They were infected by contacting with infected animals or consuming of unpasteurized milk or meat of sheep or goats, also. Standard agglutination test was positive in all patients and blood culture in 10 (62.5%) patients as well as medulloculture in 3 (18.8%) patients were positive. A combination of antibiotic treatment with rifampin plus cotrimoxazole showed good response and all clinical manifestations improved. Brucellosis is misdiagnosed frequently and should be considered in the differential diagnosis when patients do not respond to standard treatment. Blood culture, together with brucella serology test, is important and helpful in the diagnosis. MRI is a good method in differentiating those with symptoms of arthritis.

摘要

本研究旨在总结中国非流行地区儿童布鲁氏菌病的临床表现、诊断、鉴别诊断和治疗。回顾性分析了 2011 年至 2016 年间收治的 16 例确诊为布鲁氏菌病的儿童患者。记录了诊断标准、临床表现和转归。最常见的症状是发热。50%的患者有骨关节受累。他们也通过接触受感染的动物或食用未经巴氏消毒的羊奶或羊肉而感染。所有患者的标准凝集试验均为阳性,10 例(62.5%)患者血培养阳性,3 例(18.8%)骨髓培养阳性。利福平联合复方磺胺甲噁唑的抗生素治疗显示出良好的反应,所有临床表现均改善。布鲁氏菌病常被误诊,当患者对标准治疗无反应时,应考虑进行鉴别诊断。血培养结合布鲁氏菌血清学检查对诊断很重要且有帮助。MRI 是鉴别关节炎症状的一种较好的方法。

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