Xie Songsong, Zhou Yan, Zheng Rongjiong, Zuo Weize, Zhang Yan, Wang Yuanzhi, Zhang Yuexin
Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi.
The First Hospital of Shihezi University.
Medicine (Baltimore). 2019 Jul;98(27):e16247. doi: 10.1097/MD.0000000000016247.
Childhood brucellosis is a significant community health problem. It may imitate other conditions and may be misdiagnosed. Pulmonary involvement is a rare complication of childhood brucellosis.
A 23-month-old child was referred to our hospital with a 3-week history of fevers and cough. He was initially diagnosed with pneumonia.
Conventional antibiotic treatment was ineffectual. Total leukocyte count was 10,300/mm, hemoglobin was 8.5 g/dL, and platelet count was 250,000/mm. The erythrocyte sedimentation rate and procaicltonin were 25 mm/h and 0.12 ng/mL, respectively. Chest radiography showed pneumonic infiltrate in both lungs.The initial bacteriologic test results were negative. Ten days after admission, Brucella melitensis were isolated from the second blood culture. This child was cured with the 2-drug regimen (rifampin+trimethopicin-sulfamethoxazole) for 6 weeks.
The child recovered well with no occurrence of complications. The child remained asmptomatic without any signs or symptoms at a follow-up of 1 year.
Non-specific findings of pulmonary brucellosis in children often make diagnosis difficult. The second blood culture is essential. In endemic areas, children with fevers and cough should be included in the diagnosis in cases of pulmonary brucellosis.
儿童布鲁氏菌病是一个重要的社区健康问题。它可能会模仿其他病症，并且可能被误诊。肺部受累是儿童布鲁氏菌病的一种罕见并发症。
一名23个月大的儿童因发热和咳嗽3周被转诊至我院。他最初被诊断为肺炎。
常规抗生素治疗无效。白细胞总数为10300/mm，血红蛋白为8.5g/dL，血小板计数为250000/mm。红细胞沉降率和降钙素原分别为25mm/h和0.12ng/mL。胸部X线检查显示双肺有肺炎浸润。初始细菌学检测结果为阴性。入院10天后，从第二次血培养中分离出羊种布鲁氏菌。该患儿采用利福平+甲氧苄啶-磺胺甲恶唑两药联合方案治疗6周后治愈。
患儿恢复良好，未出现并发症。在1年的随访中，患儿无症状，无任何体征或症状。
儿童肺部布鲁氏菌病的非特异性表现常常使诊断困难。第二次血培养至关重要。在流行地区，发热和咳嗽的儿童在诊断肺部布鲁氏菌病时应予以考虑。
