title: Brucellosis Suspicion is the Most Important Criterion for Diagnosis Particularly in Endemic Regions.
abstract: BACKGROUND
  Brucellosis is a zoonotic infectious disease that remains endemic in developing countries. The purpose of this study is to emphasize the need for considering brucellosis as a diagnosis, since this disease has a high risk of complications among young patients when not treated appropriately.
  
  
  METHODS
  A total of 88 brucellosis cases with blood cultures that were positive for the pathogen were evaluated retrospectively in this study.
  
  
  RESULTS
  The patients included 33 males (37.5%) and 55 females (62.5%) with a median age of 8.9 years (range: 5-14 years). A total of 43.1% (n=38) of the cases included occupational exposure to animals as a possible infection source. The consumption of raw milk products, especially cheese, was present in 52.2% (n=46) of the cases. Clinically, 55 of the cases were acute (62.5%), 23 of the cases were subacute (26.2%) and 10 of the cases were chronic (11.3%). The distribution of the joint pain complaints was as follows: 62.5% (n=55) of patients reported hip pain, 22.7% (n=20) of patients reported knee pain, 11.4% (n=10) of patients reported lumbar-back pain and 3.4% (n=3) of patients reported pain in other joints. A total of 59.1% (n=52) of the cases had been examined by another doctor at least once and mistreated.
  
  
  CONCLUSIONS
  Complication rates and the rate of chronic infection increase with delayed diagnosis, and clinical doubt is the most important criterion for diagnosis, particularly in endemic regions.
authors.affiliation: Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Yilmaz
authors.affiliation: Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
authors.forename: Guzelali
authors.initials: G
authors.lastname: Ozdemir
authors.affiliation: Dr. A. Yurtaslan Ankara Onkology Training and Research Hospital, Ankara, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Aktas
authors.affiliation: Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Baran
authors.initials: B
authors.lastname: Komur
authors.affiliation: Private Sifa Hospital, Isparta, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Alfidan
authors.affiliation: Private Primer Hospital, Gaziantep, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Memisoglu
authors.affiliation: Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Tahir Mutlu
authors.initials: TM
authors.lastname: Duymuş
keywords: Brucella; brucellosis; brucellosis in children; joint pain