Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei, 230001, China.
BMC Infect Dis. 2024 Sep 8;24(1):929. doi: 10.1186/s12879-024-09843-7.
Brucellosis is a global public health concern and occurs mainly in young adults and the elderly, with children having a lower incidence, thus often leading to delayed treatment. This study aimed to describe the epidemiologic features and clinical characteristics of brucellosis in children.
In this retrospective study, the clinical data of five children diagnosed with brucellosis in Anhui Provincial Children's Hospital between January 1, 2021 and December 30, 2022 were analyzed.
All five cases were from non-pastoral areas, among which three have a history of livestock exposure and originated from the countryside. All patients had medium-high grade fever, mostly accompanied by night sweats and malaise, and three had joint pains. Laboratory tests showed that their white blood cell count was normal or mildly raised, with lymphocytes as the predominant cell population. Four patients had anemia, four had aspartate aminotransferase and alanine aminotransferase abnormality, and two had elevated ferritin levels. All blood samples were positive for Brucella culture, one of which had positive bone marrow culture, and all had positive serology test results. All patients were treated with rifampicin, in combination with sulfamethoxazole or doxycycline for 6 weeks following diagnosis. Four children had a good prognosis, but one child had recurrent joint pain.
The epidemiologic history of children from non-pastoral areas with brucellosis is often unclear; clinical manifestations and laboratory tests lack specificity; and they are easily delayed diagnosis. Clinicians should remain vigilant regarding the possibility of this disease in children with fever of unknown origin. The epidemiological history should be investigated in detail to improve the diagnostic ability of brucellosis. We recommend emphasizing serological testing. Children with brucellosis who receive timely diagnosis and standardized treatment can expect a favorable prognosis.
布鲁氏菌病是一个全球性的公共卫生关注点，主要发生在年轻人和老年人中，儿童发病率较低，因此往往导致治疗延迟。本研究旨在描述儿童布鲁氏菌病的流行病学特征和临床特征。
在这项回顾性研究中，分析了 2021 年 1 月 1 日至 2022 年 12 月 30 日期间在安徽省立儿童医院诊断为布鲁氏菌病的五例儿童的临床数据。
所有五例均来自非牧区，其中三例有牲畜接触史，来自农村。所有患者均有中高热，多伴有盗汗和不适，三例有关节痛。实验室检查显示，白细胞计数正常或轻度升高，以淋巴细胞为主。四例患者贫血，四例天门冬氨酸氨基转移酶和丙氨酸氨基转移酶异常，两例铁蛋白升高。所有血液样本均为布鲁氏菌培养阳性，其中一例骨髓培养阳性，所有血清学检测结果均为阳性。所有患者均在诊断后接受利福平治疗，联合使用磺胺甲噁唑或多西环素治疗 6 周。四例患儿预后良好，但有一例患儿出现关节痛复发。
来自非牧区的儿童布鲁氏菌病的流行病学史通常不明确；临床表现和实验室检查缺乏特异性；容易延误诊断。临床医生应警惕不明原因发热儿童患此病的可能性。应详细调查流行病学史，提高布鲁氏菌病的诊断能力。我们建议强调血清学检测。及时诊断和规范治疗的儿童布鲁氏菌病患者预后良好。
