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Clinical manifestations and complications in 1028 cases of brucellosis a retrospective evaluation and review of the literature        
Yazarlar
Turan Buzgan
Prof. Dr. Mustafa Kasım KARAHOCAGİL Prof. Dr. Mustafa Kasım KARAHOCAGİL
Kırşehir Ahi Evran Üniversitesi
Hasan Irmak
Ali Irfan Baran
Hasan Karsen
Omer Evirgen
Hayrettin Akdeniz
Özet
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. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Anahtar Kelimeler
Brucellosis | Clinical finding | Complication | Epidemiology | Laboratory finding
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
Dergi ISSN 1201-9712
Dergi Tarandığı Indeksler SCI-Expanded
Makale Dili İngilizce
Basım Tarihi 06-2010
Cilt No 14
Sayı 6
Doi Numarası 10.1016/j.ijid.2009.06.031
Makale Linki http://linkinghub.elsevier.com/retrieve/pii/S120197120900318X