title: A multicenter retrospective study of childhood brucellosis in Chicago, Illinois from 1986 to 2008.
abstract: OBJECTIVE
  To determine risk factors in children for the acquisition of Brucella, clinical presentation, treatment, and disease outcomes.
  
  
  METHODS
  A retrospective multicenter chart review was undertaken of children identified with brucellosis from 1986 to 2008 at three tertiary care centers in Chicago, Illinois, USA. The charts were reviewed for data regarding risk factors for acquisition, clinical presentation, and outcomes.
  
  
  RESULTS
  Twenty-one charts were available for review. The median age was 6.5 years (range 2-14 years); 62% were female. Ethnic background was 67% Hispanic and 24% Arabic. Risk factors included travel to an endemic area (86%), particularly Mexico, and consumption of unpasteurized milk products (76%). Common findings included fever (95%), bacteremia (86%), elevated liver transaminases (80%), constitutional symptoms (76%), splenomegaly (60%), and hepatomegaly (55%). Relapse occurred in three of six subjects started on single drug treatment, but in only one of 15 subjects who started on two or more drugs (p=0.053). No relapses occurred in children whose initial therapy included rifampin or those administered three-drug regimens.
  
  
  CONCLUSIONS
  Brucella is an infrequent pathogen but should be considered in children with compatible epidemiologic and clinical characteristics. Blood cultures should be obtained, and initial therapy with two or more drugs may decrease the risk of relapse.
authors: Rush University Medical Center, 1653 West Congress Parkway, Suite 736 Murdock, Chicago, IL 60612, USA. latania_logan@rush.edu
authors: Latania K
authors: LK
authors: Logan
authors: Norman M
authors: NM
authors: Jacobs
authors: James B
authors: JB
authors: McAuley
authors: Robert A
authors: RA
authors: Weinstein
authors: Evan J
authors: EJ
authors: Anderson
mesh_terms: D000293:Adolescent; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002002:Brucella / Q000187:drug effects / Q000302:isolation & purification*; D002006:Brucellosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002641:Chicago / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D006529:Hepatomegaly / Q000382:microbiology; D006801:Humans; D008297:Male; D008800:Mexico; D008892:Milk / Q000382:microbiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013163:Splenomegaly / Q000382:microbiology; D014195:Travel
chemical_list: D000900:Anti-Bacterial Agents