Division of Infectious Diseases, Department of Medicine, King Faisal Specialist Hospital and Research Center, Madinah, Saudi Arabia.
Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
PLoS One. 2024 Mar 27;19(3):e0299878. doi: 10.1371/journal.pone.0299878. eCollection 2024.
To evaluate the outcome of complicated osteoarticular brucellosis.
A retrospective chart review was conducted at King Abdulaziz Medical City (KAMC), in Riyadh, Saudi Arabia. All patients aged more than 14 who have been diagnosed with complicated brucellosis with osteoarticular disease between July 2016 and December 2022 were included.
A total of 82 (10.7%) patients met the criteria, with a male predominance of 66 (80.4%), and their mean age was 56.4 ± 19.3 years. A positive blood culture was found in 33 (40.2%). The most common clinical presentation was fever (57.3%). All patients received a doxycycline-based regimen except one. 62 (75.60%) patients were treated with three or more medication regimens, while 20 (24.40%) patients received two drug regimens. The mean duration of therapy was 94.2 days for two-drug therapy and 116.4 days for three-drug therapy. A total of 78 out of 82 (95.1%) cases were cured at the end of treatment. Unfavorable outcomes were documented in four cases (two relapses and two treatment failures). Neither using three drugs regimen nor longer duration of therapy was associated with better outcome.
Unfavorable outcomes have been noticed to be minimal in our cohort of patients with osteoarticular brucellosis, treated mainly with a three-drug regimen and a longer duration of therapy.
评估复杂骨关节布鲁氏菌病的结局。
对沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城(KAMC)进行回顾性病历审查。所有年龄大于 14 岁、2016 年 7 月至 2022 年 12 月期间被诊断为伴有骨关节疾病的复杂布鲁氏菌病的患者均被纳入研究。
共有 82 名(10.7%)患者符合标准,男性占 66 名(80.4%),平均年龄为 56.4 ± 19.3 岁。33 名(40.2%)患者的血液培养呈阳性。最常见的临床表现是发热(57.3%)。除 1 例外,所有患者均接受了基于强力霉素的方案治疗。62 名(75.60%)患者接受了 3 种或更多药物方案治疗,20 名(24.40%)患者接受了 2 种药物方案治疗。两种药物方案的治疗时间平均为 94.2 天,三种药物方案的治疗时间平均为 116.4 天。在治疗结束时,82 例中有 78 例(95.1%)治愈。有 4 例(2 例复发和 2 例治疗失败)记录到不良结局。使用三种药物方案或延长治疗时间与更好的结局均无相关性。
在我们的骨关节布鲁氏菌病患者队列中,不良结局发生率较低,主要采用三种药物方案和较长的治疗时间。