Deniz Melis, Şenol Hande, Parlak Kerim, Kabar Feyza
Department of Pediatric Infectious Diseases, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey.
Department of Biostatistics, Pamukkale University, Denizli, Turkey.
Am J Trop Med Hyg. 2024 May 14;111(2):305-311. doi: 10.4269/ajtmh.23-0586. Print 2024 Aug 7.
Brucellosis is a zoonotic disease that mimics many other diseases, making diagnosis difficult in pediatric patients. If the clinical signs of the disease are not well known and there is a delay in diagnosis and treatment, complicated brucellosis involving different body sites can develop. This study aimed to analyze the demographics, clinical information, laboratory test results, and imaging findings of children with brucellosis. Particular attention was paid to the involvement of organs and potential complications. Pediatric patients diagnosed with brucellosis at the Sanlıurfa Training and Research Hospital in Turkey were retrospectively evaluated. In total, 101 patients diagnosed with brucellosis were included in this study. Bone-joint involvement was observed in 21 (20.7%) patients. High Brucella Coombs gel test (CT) titers (≥1/640) and increased erythrocyte sedimentation rate (ESR) were significant in the bone-joint brucellosis group (P = 0.022 and P = 0.0205, respectively). Fourteen (13.9%) patients had at least one organomegaly in which Brucella CT titers and C-reactive protein (CRP) levels were substantially higher than those in patients without organomegaly (P = 0.02 and P = 0.0049, respectively). Anemia, leukopenia, and thrombocytopenia were observed in 36 (35.6%), 10 (9.9%), and 4 (3.9%) patients, respectively. At least one elevation in liver function test (LFT) results was observed in 32 (31.7%) patients. High acute-phase reactants, such as ESR, CRP levels, and Brucella CT titers, may help identify complicated brucellosis. This study highlights that pediatric brucellosis can lead to cytopenia and elevated LFT results and should therefore be considered as a differential diagnosis.
布鲁氏菌病是一种人畜共患疾病,症状与许多其他疾病相似,这使得儿科患者的诊断变得困难。如果对该疾病的临床症状了解不足,且诊断和治疗出现延误,就可能发展为累及身体不同部位的复杂性布鲁氏菌病。本研究旨在分析布鲁氏菌病患儿的人口统计学特征、临床信息、实验室检查结果及影像学表现。特别关注了器官受累情况及潜在并发症。对在土耳其尚勒乌尔法培训与研究医院被诊断为布鲁氏菌病的儿科患者进行了回顾性评估。本研究共纳入101例被诊断为布鲁氏菌病的患者。21例(20.7%)患者出现骨关节受累。布鲁氏菌库姆斯凝胶试验(CT)高滴度(≥1/640)和红细胞沉降率(ESR)升高在骨关节布鲁氏菌病组中具有显著性(P值分别为0.022和0.0205)。14例(13.9%)患者出现至少一种器官肿大,其布鲁氏菌CT滴度和C反应蛋白(CRP)水平显著高于未出现器官肿大的患者(P值分别为0.02和0.0049)。分别有36例(35.6%)、10例(9.9%)和4例(3.9%)患者出现贫血、白细胞减少和血小板减少。32例(31.7%)患者的肝功能检查(LFT)结果至少有一项升高。ESR、CRP水平和布鲁氏菌CT滴度等高急性期反应物可能有助于识别复杂性布鲁氏菌病。本研究强调,儿科布鲁氏菌病可导致血细胞减少和LFT结果升高,因此应将其视为鉴别诊断的考虑因素。