Clinical, Laboratory, and Epidemiological Characteristics of Patients Diagnosed with Brucellosis: A Comprehensive Analysis

Year 2023, , 461 - 469, 29.12.2023

Yeliz Çiçek , Nida Özcan Yakup Demir , Saim Dayan

https://doi.org/10.5798/dicletip.1411498

Abstract

Introduction: This study aims to evaluate the demographic characteristics, clinical manifestations, laboratory findings, radiological features, and the relationship between brucella capture titers and blood culture positivity in patients followed up due to brucellosis.
Methods: The medical records of 214 patients diagnosed with brucellosis, who were followed up at the infectious diseases clinic and/or outpatient clinic between January 2017 and December 2018, were retrospectively reviewed. Demographic and clinical characteristics of 118 included patients were recorded. Brucella capture tests and blood cultures were processed at bacteriology department of Dicle University Hospital Laboratory.
Results: The mean age of the patients was 39.54±17.123 years. Fifty percent of the patients were male and 58.5% of the patients resided in rural areas. The most common complaints at presentation were fever (89%) and bone-joint pain (73.7%). The most frequent physical examination findings were fever (89%) and tenderness in bones and joints (73.7%). Elevated erythrocyte sedimentation rate was observed in 29.6% of patients, while elevated c-reactive protein levels were seen in 55.9% of the patients. The two most common hematological findings at the time of diagnosis were anemia with 45.8% and lymphomonocytosis with 26.3%. A statistically significant disparity was observed in the incidence of complications among patients displaying hematological manifestations, including anemia, leukopenia, and thrombocytopenia, associated with brucellosis (p<0.05). The most commonly encountered organ involvements were sacroiliitis, with a prevalence of 31.4%, and splenomegaly, noted in 25.4% of cases. Among the patient cohort, disease reporting was documented in 59.3% of instances. The reporting rate was notably higher at the infectious diseases clinic, accounting for 64.7% of cases, whereas non-infectious clinics exhibited a lower reporting rate of 25%. Blood cultures were taken from 56 of 118 patients followed up due to brucellosis and growth was detected in 30 of them. All of the microorganisms grown were determined to be B. Melitensis. Notably, 62.5% of patients with a brucella capture titer ≥1/ 1280 and 31.25% of those with titers <1/ 1280 exhibited growth in blood cultures. There was a statistically significant correlation between the elevation of brucella capture titers among patients, ranging from 1/320 to 1/5120, and an increased likelihood of detecting brucella bacteria through blood culture (p<0.05).
Conclusion: This study revealed a correlation between higher brucella capture titers and blood culture positivity. In addition, markers such as anemia, leukopenia, and thrombocytopenia were associated with an increased risk of complications, emphasizing their importance as prognostic indicators.

Keywords

brucella capture, blood culture, complication.

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