Pediatric Brucellosis: A Retrospective Evaluation of 82 Cases - Original Investigation

Objective: The Southeast Anatolia region of Turkey is a geographic area with endemic brucellosis. This study aimed to evaluate brucellosis cases in respect of epidemiology, clinical and laboratory findings and response to treatment. Material and Methods: A retrospective evaluation was made of 82 cases diagnosed with brucellosis between January 2009 and September 2011 in terms of age, gender, complaints on presentation, risk of infection, family history, physical examination findings, laboratory test results and treatment applied. Diagnosis was made by high brucellosis agglutination titer and/or bacterial growth in culture.Results: The cases comprised 37 males and 45 females with a mean age of 11.96±3.57 years (range 5-16 years). The majority of cases (76.8%) were the children of rural families engaged in agriculture and livestock production. The most common reasons for attendance were fever (86.6%), joint pain (75.6%), fatigue (51.2%) and sweating (37.8%). Physical examination determined fever (90.2%), arthritis (26.8%), splenomegaly (22%), hepatomegaly (20.7%) and lymphadenopathy (14.6%). The brucella agglutination titer was ≥1/160 in all cases. Reproduction was seen in the blood culture of 1 patient and in the cerebral spinal fluid of 1 patient. A combination therapy of doxycycline and rifampicin was administered to 68 patients aged 8 years and older, and trimethroprim-sulfamethoxazole (TMP/SMX) and rifampicin to 14 patients under 8 years old.Conclusion: There may be many different clinical signs of brucellosis. In areas where the disease is endemic, it should be considered primarily, especially in patients who present with fever and joint pain