Clinical manifestations, laboratory findings, and therapeutic regimen in hospitalized children with brucellosis in an Iranian Referral Children Medical Centre.
Brucellosis is considered a known widespread zoonotic disease and is endemic in Mediterranean region, like Iran. This study reviewed the clinical manifestations, laboratory findings, and therapeutic regimen in childhood brucellosis in Iran. In this retrospective study, we reviewed hospital-records of 34 consecutive children with a confirmed diagnosis of brucellosis among a total number of 10,864 patients admitted to Children's Medical Center, Tehran, Iran, between 2002 and 2010. Among the patients diagnosed with brucellosis, 22 (65%) were admitted during spring and summer. Clinical findings of these patients at admission were arthritis, splenomegaly, hepatomegaly, lymphadenopathy, maculopapular skin rashes, and fever. Anaemia (53%) and leukopenia (33%) were the most common findings in the children. Only one patient had presented with leukocytosis. Four children (12%) were thrombocytopenic, and none of patients had pancytopenia. Blood cultures were positive in 5 patients (23%). Only one patient underwent bone-marrow aspiration and had positive culture for Brucella spp. Positive titres were found in 33 cases (97%) in Wright test, 23 cases (96%) in Coombs test, and 16 patients (72.7%) in 2ME (2-Mercaptoethanol) test. In one case, Wright and Coombs test titres were below 1:80 while Brucella spp. were isolated from blood at the same time. It is concluded, prolonged fever with joint involvement and organomegaly may increase possibility of infection with Brucella spp. Appropriate treatment regimen by more tolerable oral drugs, with a duration of at least 8 weeks, is recommended.
Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Fatemeh
F
Fanni
Leila
L
Shahbaznejad
Babak
B
Pourakbari
Shima
S
Mahmoudi
Setareh
S
Mamishi
D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001168:Arthritis / Q000209:etiology; D002006:Brucellosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000379:methods; D005076:Exanthema / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D007492:Iran; D007753:Laboratories; D008206:Lymphatic Diseases / Q000209:etiology; D008297:Male; D012017:Referral and Consultation; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D013163:Splenomegaly / Q000209:etiology; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use
D000890:Anti-Infective Agents; D014295:Trimethoprim; D013420:Sulfamethoxazole; D004318:Doxycycline; D012293:Rifampin