title: Respiratory system involvement in brucellosis: the results of the Kardelen study.
abstract: BACKGROUND
  Pulmonary involvement is a rare complication of brucellosis. We describe the largest series to date, to our knowledge, of patients with pulmonary brucellosis.
  
  
  METHODS
  This 10-year, retrospective, descriptive study involved 27 centers in Turkey, including all patients with brucellosis with confirmed respiratory system involvement.
  
  
  RESULTS
  Of 133 patients (67 men), 123 (92.5%) had acute infection (defined as &lt; 2 months), with an overall mean ± SD duration of symptoms of 33.9 ± 8.5 days. The radiologic pattern of pulmonary disease was consolidation/lobar pneumonia in 91 patients (68.4%) and pleural effusion in 41 patients (30.8%), including 30 (22.5%) with both. Moreover, 23 patients (17.3%) had bronchitis (one with coexistent pneumonia), and 10 (7.5%) had nodular lung lesions (one with coexistent pneumonia and effusion). Blood culture results were positive in 56 of 119 patients, and all other cases were serologically confirmed. None of 60 sputum specimens and two of 19 pleural fluid samples (10.5%) yielded positive culture results for brucellosis. Other features of brucellosis, such as osteoarticular complications, were detected in 61 patients (45.9%); 59 (44.4%) had raised liver transaminase levels, and 59 (44.4%) had thrombocytopenia. Fifteen patients (11.3%) required management in an ICU for an average of 3.8 ± 2.2 days. All patients responded to standard combination antimicrobial therapy for brucellosis with no deaths, although treatment regimens required modification in seven patients.
  
  
  CONCLUSIONS
  Brucellosis with pulmonary involvement is rare but has a good prognosis following treatment with appropriate antibiotics. Many clues in the exposure history, presenting clinical features, and baseline blood tests should alert the clinician to consider brucellosis.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. Electronic address: hakanerdem1969@yahoo.com.
authors.forename: Hakan
authors.initials: H
authors.lastname: Erdem
authors.affiliation: GATA Haydarpasa Training Hospital, and Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Asuman
authors.initials: A
authors.lastname: Inan
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: Nazif
authors.initials: N
authors.lastname: Elaldi
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Tekin
authors.affiliation: Dicle University School of Medicine, and Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Serda
authors.initials: S
authors.lastname: Gulsun
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Ataman-Hatipoglu
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, England.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Beeching
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Özcan
authors.initials: Ö
authors.lastname: Deveci
authors.affiliation: Ankara Training and Research Hospital, and Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Aysun
authors.initials: A
authors.lastname: Yalci
authors.affiliation: GATA Haydarpasa Training Hospital, and Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Bolukcu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Gaziantep State Hospital, Gaziantep, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Dagli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001991:Bronchitis / Q000175:diagnosis* / Q000188:drug therapy; D002006:Brucellosis / Q000175:diagnosis* / Q000188:drug therapy; D002443:Ceftriaxone; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis* / Q000188:drug therapy; D011014:Pneumonia / Q000175:diagnosis* / Q000188:drug therapy; D011379:Prognosis; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D013307:Streptomycin / Q000627:therapeutic use; D014421:Turkey; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D004318:Doxycycline; D012293:Rifampin; D013307:Streptomycin