Document Detail


Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature.
MedLine Citation:
PMID:  19910232     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Brucellosis is the most prevalent bacterial zoonosis worldwide. In this study, we aimed to compare our 1028 brucellosis cases with other big series in the literature in view of epidemiological, clinical, and laboratory findings and therapeutic features. METHODS: A total of 1028 brucellosis cases admitted to the Department of Infectious Diseases and Clinical Microbiology over a 10-year period were included in the study. A retrospective analysis was undertaken and patient files were reviewed for history, clinical and laboratory findings, and therapeutic features, as well as complications. RESULTS: Of the 1028 patients, 539 (52.4%) were female and 489 (47.6%) were male. The mean age of patients was 33.7+/-16.34 years and 69.6% of cases were aged 13-44 years. Four hundred and thirty-five cases (42.3%) had a history of raising livestock and 55.2% of the cases were found to have no occupational risk for brucellosis. Six hundred and fifty-four of the cases (63.6%) had a history of raw milk and dairy products consumption. The most frequently seen symptoms were arthralgia (73.7%) and fever (72.2%), while the most common clinical findings were fever (28.8%) and hepatomegaly (20.6%). The most frequent laboratory finding was a high C-reactive protein level (58.4%). The standard tube agglutination (STA) test+Coombs STA test was positive in 1016 cases (98.8%). Focal involvement was present in 371 (36.1%) cases. The most frequent involvement was osteoarticular involvement with 260 cases (25.3%). The overall relapse rate for patients with brucellosis was 4.7%. The highest relapse rate, 8.5%, was observed in the group of patients with osteoarticular involvement. Regimens including doxycycline and streptomycin with or without rifampin appeared more effective than other regimens in osteoarticular involvement. CONCLUSIONS: In humans, brucellosis may lead to serious morbidity, and it continues to be a major health problem in Turkey. There is no recommended treatment protocol for complicated brucellosis. Large multicenter studies are needed to determine the most appropriate treatment choices and durations in complicated brucellosis.
Authors:
Turan Buzgan; Mustafa Kasim Karahocagil; Hasan Irmak; Ali Irfan Baran; Hasan Karsen; Omer Evirgen; Hayrettin Akdeniz
Publication Detail:
Type:  Journal Article; Review     Date:  2009-11-11
Journal Detail:
Title:  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases     Volume:  14     ISSN:  1878-3511     ISO Abbreviation:  Int. J. Infect. Dis.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-20     Completed Date:  2010-09-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610933     Medline TA:  Int J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e469-78     Citation Subset:  IM    
Copyright Information:
Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Directorate of Basic Health Services, Ministry of Health, Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arthralgia / diagnosis,  microbiology
Arthritis / microbiology
Bone Diseases / diagnosis,  microbiology
Brucellosis / complications*,  diagnosis*,  drug therapy,  epidemiology
Child
Child, Preschool
Dairy Products / microbiology
Female
Fever / diagnosis,  microbiology
Hepatomegaly / diagnosis,  microbiology
Humans
Male
Middle Aged
Nervous System Diseases / microbiology
Occupational Diseases / epidemiology,  microbiology
Retrospective Studies
Risk Factors
Turkey / epidemiology

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