Qasim Salman S, Alshuwaier Khalid, Alosaimi Mohammed Q, Alghafees Mohammad A, Alrasheed Abdullah, Layqah Laila, Baharoon Salim
Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Pharmacy, King Abdullah International Medical Research Center, Riyadh, SAU.
Cureus. 2020 Nov 1;12(11):e11289. doi: 10.7759/cureus.11289.
Background Brucellosis, an endemic disease in Saudi Arabia, has an infection rate of 70 per 100,000 people, with a varying morbidity rate in different parts of the country. The aim of this study was to assess the epidemiological and clinical features, laboratory findings, treatment modalities, complications, and outcomes in children with brucellosis. Materials and methods The medical records of 153 patients attending King Abdullah Specialist Children's Hospital in Riyadh, Saudi Arabia, from January 2015 to January 2019 were reviewed retrospectively. Demographic data, laboratory test results, serum agglutination test titer, and the results of the blood cultures were obtained. The diagnosis of brucellosis was based on compatible signs and symptoms with a positive serology titer of ≥1:160 or a blood culture positive for species. Results The majority of the sample (69.6%, n=107) were males, with a mean age of 7.75 ± 3.28 years. Ingestion of unpasteurized camel dairy products was the most frequent transmission risk factor. The most prevalent presenting symptoms were constitutional and musculoskeletal symptoms. Six patients (3.9%) had complicated brucellosis, with neurobrucellosis diagnosed in three cases. Hospitalization for brucellosis was required in 15% of the patients. The majority (99.35%, n=152) of the patients had a serum agglutination test (SAT) titer of ≥1:160. A blood culture was positive in 52 (34%) of the 111 patients tested. The most frequently prescribed regimen was rifampicin + co-trimoxazole in 81 (52.9%) patients. Relapse occurred in a small proportion (4.6%, n=7), and the majority (95.4%, n=146) had a complete remission. Conclusions The main route of transmission was the ingestion of unpasteurized dairy products. Brucellosis had a wide range of clinical presentation, involving multiple organ systems. Neurobrucellosis was the most frequent complication. The SAT was the most useful and reliable test for the diagnosis of brucellosis. Most patients were successfully treated with rifampicin and co-trimoxazole for six weeks.
布鲁氏菌病是沙特阿拉伯的一种地方病，感染率为每10万人中有70人，该国不同地区的发病率有所不同。本研究的目的是评估儿童布鲁氏菌病的流行病学和临床特征、实验室检查结果、治疗方式、并发症及预后。材料与方法：回顾性分析了2015年1月至2019年1月在沙特阿拉伯利雅得阿卜杜拉国王专科医院就诊的153例患者的病历。获取了人口统计学数据、实验室检查结果、血清凝集试验滴度及血培养结果。布鲁氏菌病的诊断基于符合症状体征且血清学滴度≥1:160阳性或血培养检出布鲁氏菌属。结果：大部分样本（69.6%，n = 107）为男性，平均年龄为7.75±3.28岁。摄入未巴氏消毒的骆驼乳制品是最常见的传播危险因素。最常见的症状是全身症状和肌肉骨骼症状。6例患者（3.9%）患有复杂性布鲁氏菌病，其中3例诊断为神经布鲁氏菌病。15%的患者因布鲁氏菌病需要住院治疗。大部分患者（99.35%，n = 152）血清凝集试验（SAT）滴度≥1:160。在111例接受检测的患者中，52例（34%）血培养呈阳性。最常用的治疗方案是利福平+复方新诺明，共81例（52.9%）患者使用。一小部分患者（4.6%，n = 7）复发，大部分患者（95.4%，n = 146）完全缓解。结论：主要传播途径是摄入未巴氏消毒的乳制品。布鲁氏菌病临床表现广泛，累及多个器官系统。神经布鲁氏菌病是最常见的并发症。SAT是诊断布鲁氏菌病最有用且可靠的检查。大多数患者接受利福平和复方新诺明治疗六周后成功治愈。
