J Pediatr Infect Dis 2022; 17(03): 143-147
DOI: 10.1055/s-0042-1745837
Original Article

Childhood Brucellosis: A Single-Center Experience from the Central Mediterranean Region of Turkey

1   Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Medicine, Suleyman Demirel University, Isparta, Turkey
,
2   Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Suleyman Demirel University, Isparta, Turkey
,
3   Division of Pediatric Neurology, Department of Pediatrics, School of Medicine, Suleyman Demirel University, Isparta, Turkey
,
4   Division of Pediatric Endocrinology, Department of Pediatrics, School of Medicine, Suleyman Demirel University, Isparta, Turkey
,
5   Division of Pediatric Cardiology, Department of Pediatrics, School of Medicine, Suleyman Demirel University, Isparta, Turkey
,
6   Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Medicine, Suleyman Demirel University, Isparta, Turkey
› Author Affiliations

Abstract

Objective Brucellosis is an important zoonotic disease in developing countries, which can occur with varying clinical findings and cause complications. The aim of this study was to evaluate cases diagnosed with brucellosis that were followed up in our clinic over the last 10 years.

Methods A retrospective evaluation was made of cases diagnosed with brucellosis and then followed up and treated as inpatients or outpatients in our clinic between January 2011 and 2021. Patient data were obtained from the hospital automated records system.

Results This study included 81 cases comprising 43 (53.1%) males and 38 (46.9%) females with a mean age of 10.7 ± 4.5 years (range, 13 months–18 years). There was a history of consuming unpasteurized milk and/or dairy products in 69 (85.2%) patients, living in a rural location in 66 (81.3%), and the family keeping livestock in 49 (60.5%) cases; there was a family history of brucellosis in 31 (38.3%) cases. The most common complaint at presentation was joint pain in 71.6%, the most common finding on physical examination was fever (59.3%), and the most common laboratory finding was elevated C-reactive protein (71.6% of cases). Brucella spp. were isolated from 12 of 43 patients who had blood cultures performed. Complications occurred in 33 (40.7%) cases, most commonly involving the osteoarticular system.

Conclusion Priority should be given to family education about not consuming raw animal products. Animals should be checked, vaccinated, and treated with a multidisciplinary approach. Until the clinical condition in endemic areas is proven to be due to a different cause, patients should be examined with the suspicion that any clinical finding may be due to brucellosis.



Publication History

Received: 06 December 2021

Accepted: 22 February 2022

Article published online:
17 May 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Centers for Disease Control (CDC) Brucellosis Reference Guide. 2017 . Accessed May 23, 2019 at: https://www.cdc.gov/brucellosis/pdf/brucellosi-reference-guide.pdf
  • 2 Seleem MN, Boyle SM, Sriranganathan N. Brucellosis: a re-emerging zoonosis. Vet Microbiol 2010; 140 (3-4): 392-398
  • 3 Brucellosis Incidence Map, Turkey, 2017. Accessed March 4, 2022 at: https://hsgm.saglik.gov.tr/depo/birimler/zoonotik-vektorel-hastaliklar-db/zoonotik-hastaliklar/9-Bruselloz/3-istatistik/Web_Bruselloz_haritasi.pdf
  • 4 Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005; 352 (22) 2325-2336
  • 5 Corbel MJ. Brucellosis in humans and animals. Produced by the World Health Organization in collaboration with the Food and Agriculture Organization of the United Nations and World Organisation for Animal Health. ISBN 92 4 154713 8 (NLM classification: WC 310) ISBN 978 92 4 154713
  • 6 Aygen B, Doganay M, Sumerkan B, Yıldız O, Kayabaş Ü. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Mal Infect 2002; 32: 485
  • 7 Bosilkovski M, Keramat F, Arapović J. The current therapeutical strategies in human brucellosis. Infection 2021; 49 (05) 823-832
  • 8 Kaplan Bulut İ, Bulut MO, Büyükkayhan D, İçağasıoğlu D, Kara S. Brucellosis in childhood: evaluation of the cases on follow. C. Ü. Tıp Fakültesi Dergisi 2005; 27 (04) 133-136
  • 9 An CH, Liu ZG, Nie SM. et al. Changes in the epidemiological characteristics of human brucellosis in Shaanxi Province from 2008 to 2020. Sci Rep 2021; 11 (01) 17367
  • 10 Dutta D, Sen A, Gupta D. et al. Childhood brucellosis in Eastern India. Indian J Pediatr 2018; 85 (04) 266-271
  • 11 Bukhari EE. Pediatric brucellosis. An update review for the new millennium. Saudi Med J 2018; 39 (04) 336-341
  • 12 Al Hashan GM, Abo El-Fetoh NM, Nasser IA. et al. Pattern of childhood brucellosis in Najran, south Saudi Arabia in 2013-2017. Electron Physician 2017; 9 (12) 5902-5907
  • 13 Helvacı M, Atila D, Barışık V. The retrospective evaluation of 57 cases with brucellosis in childhood. J Tepecik Educ Res Hospital 2011; 21 (03) 135-138
  • 14 Tanir G, Tufekci SB, Tuygun N. Presentation, complications, and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009; 51 (01) 114-119
  • 15 Çelebi S, Hacımustafaoğlu M, Demirtaş F, Salı E, Gül Ü.. Brucellosis in childhood. J Pediatr Inf 2011; 5: 59-62
  • 16 Buzgan T, Karahocagil MK, Irmak H. et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis 2010; 14 (06) e469-e478
  • 17 Yüce A, Alp-Çavuş S. Brucellosis in Turkey. A review. Klimik Derg 2006; 19 (03) 87-97
  • 18 Savas L, Onlen Y, Savas N, Yapar AF. Prospective evaluation of 140 patients with brucellosis in the southern region of Turkey. Infect Dis Clin Pract 2007; 15: 83-88
  • 19 Demiroğlu YZ, Turunç T, Alişkan H, Colakoğlu S, Arslan H. Brucellosis: retrospective evaluation of the clinical, laboratory and epidemiological features of 151 cases [in Turkish]. Mikrobiyol Bul 2007; 41 (04) 517-527
  • 20 Demir MI, Kader Ç, Çolan YN, Kocabıyık O, Erbay A. Evaluation of brucellosis cases. Bozok Med J. 2017; 7 (03) 47-51
  • 21 Yoldas T, Tezer H, Ozkaya-Parlakay A, Sayli TR. Clinical and laboratory findings of 97 pediatric brucellosis patients in central Turkey. J Microbiol Immunol Infect 2015; 48 (04) 446-449
  • 22 Ataman-Hatipoğlu Ç, Kınıklı S, Tülek N, Tekin-Koruk S, Arslan S. Bir eğitim hastanesinin infeksiyon hastalıkları ve klinik mikrobiyoloji kliniğinde izlenen 202 bruselloz olgusunun epidemiyolojik verilerinin irdelenmesi. Klimik Derg 2005; 18 (03) 94-98
  • 23 Kazak E, Akalın H, Yılmaz E. et al. Brucellosis: a retrospective evaluation of 164 cases. Singapore Med J 2016; 57 (11) 624-629
  • 24 Abuhandan M, Güzel B, Çakmak A, Çiçek A. Pediatric brucellosis: a retrospective evaluation of 82 cases. J Pediatr Inf 2012; 6: 74-78
  • 25 Young EJ. Brucella species. In: Mandell GL, Bennett JE, Dolin R. eds. Principles and Practise of Infectious Diseases. Philadelphia: Churchill Livingstone; 2010: 2921-2925
  • 26 Skalsky K, Yahav D, Bishara J, Pitlik S, Leibovici L, Paul M. Treatment of human brucellosis: systematic review and meta-analysis of randomised controlled trials. BMJ 2008; 336 (7646): 701-704
  • 27 Solera J. Update on brucellosis: therapeutic challenges. Int J Antimicrob Agents 2010; 36 (Suppl. 01) S18-S20
  • 28 del Pozo JSG, Solera J. Treatment of Human Brucellosis–Review of Evidence from Clinical Trials. Updates on Brucellosis. London: Intech Open; 2015
  • 29 Shaalan MA, Memish ZA, Mahmoud SA. et al. Brucellosis in children: clinical observations in 115 cases. Int J Infect Dis 2002; 6 (03) 182-186
  • 30 Benjamin B, Khan MRH. Hip involvement in childhood brucellosis. J Bone Joint Surg Br 1994; 76 (04) 544-547
  • 31 Habeeb YKR, Al-Najdi AKN, Sadek SAH, Al-Onaizi E. Paediatric neurobrucellosis: case report and literature review. J Infect 1998; 37 (01) 59-62