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The evaluation of brucellosis in children in an endemic region of Turkey, Van

Year 2013, Volume: 19 Issue: 1, 1 - 4, 01.02.2013

Erdal Sarı İlkay Özgen Sarı Aysu Say Feray Güven Almala Pınar Ulutaş

https://doi.org/10.5455/GMJ-30-2012-111

Abstract

Brucellosis is an important infectious disease especially endemic in Eastern and Southeastern Turkey. In this study, we aimed to evaluate the clinical, laboratory and treatment results of Brucellosis in children. Children with nonspecific findings suggestive of Brucellosis were included from September 2010 to February 2011 from the outpatient clinic. The symptoms, physical findings and laboratory values are analyzed in 43 children who were diagnosed as Brucellosis.The mean age of children was 9.3 years (range: 4-13 years), 51%n:22) were male. Most common complaint was fatigue (100%), myalgia (100%) and weight loss (86%). Arthritis (48%), lymphadenopathy (6%), and splenomegaly (13%) has been identified. Laboratory values revealed high sedimentation rates (51%), high AST/ALT (65%), high CRP levels (72%). Brucella agglutination test was positive in all of the patients. Brucella was identified in 6% of blood cultures. All of the patients were treated with antibiotics of least two-drug combination. The relapse rate was 11% (n=5) and no mortality was observed. Brucellosis is an important health issue, especially in endemic regions, necessitating preventive measures and effective treatment.

Keywords

Brucellosis; children; laboratory values; treatment.

References

  • American Academy of Pediatrics. Brucellosis. In:Pickering LK, ed. 2009 Red Book: Report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics 2009;237-239.
  • Schutze GE, Jacobs RF. Brucella. In: Behrman RE, Kliegman RM, Jenson HB, ed. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: WB Saunders, 2004;939-941.
  • Hall WH. Brucellosis. In: Evans AS, Brachman PS, ed. Bacterial Infections of Humans. 2nd ed. New York: Plenum Publishing, 1991;133–151.
  • Young EJ. Brucella species. In: Mandell GL, Bennett JE, Dolin R, ed. Principles and Practice of Infectious Diseases. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Elsevier Churchill Livingstone, 2003;2669–2672. www.saglik.gov.tr/istatistikler (Erişim: Ekim 2010).
  • Palanduz A, Palanduz S, Guler N. Brucellosis in a mother and her young infant: probable transmission by breast milk. Int J Infect Dis 2000;4:55-6.
  • Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance. MMWR Recomm Rep 1997;46:1-55.
  • Alişkan H. The value of culture and serological methods in the diagnosis of human brucellosis. Mikrobiyol Bul 2008;42:1859
  • Celebi S, Hacımustafaoğlu M, Yılmaz E. Çocuklarda norobruselloz: uc vaka takdimi. Cocuk Sağlığı ve Hastalıkları Dergisi 2004;47:46-9.
  • Ragan VE. The Animal and Plant Health Inspection Service (APHIS) Brucellosis Eradication Program in the United States. Vet Microbiol 2002;90:11–8.
  • Buzgan T, Karahocagil MK, Irmak H, Baran AI, Karsen H, Evirgen O, et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis 2010;14:469-78.
  • Tanir G, Tufekci SB, Tuygun N. Presentation, complications, and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009;51:114-9.
  • Çelebi S, Hacımustafaoğlu M, Demirtaş F, Salı S, Gül Ü, Özel M. Çocukluk Çağında Brusello; J Pediatr Inf 2011;5:59-62.
  • Wallach JC, Miguel SE, Baldi PC, Guarnera E, Goldbaum FA, Fossati CA. Urban outbreak of a Brucella melitensis infection in an Argentine family: clinical and diagnostic aspects. FEMS Immunol Med Microbiol 1994;8:49- 56.
  • Abramson O, Rosenvasser Z, Block C, Dagan R. Detection and treatment of brucellosis by screening a population at risk. Pediatr Infect Dis J 1991;10:434-8.
  • Karadağ-Öncel E, Özsürekci Y, Cengiz AB, Kara A, Ceyhan M, Çelik M, ve ark. Çocukluk çağında bruselloz: Hacettepe Üniversitesi deneyimi; Çocuk Sağlığı ve Hastalıkları Dergisi 2011;54:135-41.
  • Shaalan MA, Memish ZA, Mahmoud SA, Alomari A, Khan MY, Almuneef M, et al. Brucellosis in children: clinical observations in 115 cases. Int J Infect Dis 2002;6:182–6.
  • Al-Eissa YA, Kambal AM, al-Nasser MN, al-Habib SA, alFawaz IM, al-Zamil FA. Childhood brucellosis: a study of 102 cases. Pediatr Infect Dis J 1990;9:74–9.
  • Shen MW. Diagnostic and therapeutic challenges of childhood brucellosis in a nonendemic country. Pediatrics 2008;121:11788
  • Secmeer G, Ecevit Z, Gulbulak B, Ceyhan M, Kanra G, Anlar Y. Splenic abscess due to brucella in childhood: a case report. Turk J Pediatr 1995;37:403-6.
  • Omar FZ, Zuberi S, Minns RA. Neurobrucellosis in childhood: six new cases and a review of the literature. Dev Med Child Neurol 1997;39:762-5.
  • Karakukcu M, Patıroğlu T, Ozdemir MA, Guneş T, Gumuş H, Karakukcu C. Pancytopenia, a rare hematologic manifestation of brucellosis in children. J Hematol Oncol 2004;26:803-6.
  • Shalev H, Abramson O, Levy J. Hematologic manifestations of brucellosis in children. Pediatr Infect Dis J 1994;13:543-5.
  • Gur E, Yildiz I, Celkan T, Can G, Akkus S, Arvas A, et al. Prevalence of anemia and the risk factors among school children in Istanbul. J Trop Pediatr 2005;51:346-50.
  • Yılmaz K, Bayraktaroğlu Z, Sivaslı E, Güler E, Balat A, Kılınç M, ve ark. Bruselloz tanılı çocuk hastalarda klinik ve laboratuvar verilerinin değerlendirilmesi. Çocuk Dergisi 2004;4:102-6.
  • Ariza J, Gudiol F, Pallares R, Viladrich PF, Rufi G, Corredoira J. Treatment of human brucellosis with doxycycline plus rifampin or doxycycline plus streptomycin: a randomized, double-blind study. Ann Intern Med 1992;117:25-30.
  • Agalar C, Usubutun S, Turkyilmaz R. Ciprofloxacin and rifampicin versus doxycycline and rifampicin in the treatment of brucellosis. Eur J Clin Microbiol Infect Dis 1999;18:535-8.
  • Palanduz A, Telhan l, Kadıoğlu LE, Erdem E, Ozturk AO. Çocukluk Çağında Bruselloz: 43 Olgunun Değerlendirilmesi. Cocuk Enfeksiyon Dergisi 2007;1:139-42.
  • Khuri-Bulos NA, Daoud AH, Azab SM. Treatment of childhood brucellosis: results of a prospective trial on 113 children. Pediatr Infect Dis J 1993;12:377–81.
  • Roushan MR, Mohraz M, Janmohammadi N, Hajiahmadi M. Efficacy of cotrimoxazole and rifampin for 6 or 8 weeks of therapy in childhood brucellosis. Pediatr Infect Dis J 2006;25:544-5.
  • Lubani MM, Dudin KI, Sharda DC, Ndhar DS, Araj GF, Hafez HA, et al. A multicenter therapeutic study of 1100 children with brucellosis. Pediatr Infect Dis J 1989;8:75–8.
  • Hall WH. Modern chemotherapy for brucellosis in humans. Rev Infect Dis 1990;12:1060-99.

Türkiye'nin endemik bölgesi Van'da çocuk bruselloz hastalarının incelenmesi

Year 2013, Volume: 19 Issue: 1, 1 - 4, 01.02.2013

Erdal Sarı İlkay Özgen Sarı Aysu Say Feray Güven Almala Pınar Ulutaş

https://doi.org/10.5455/GMJ-30-2012-111

Abstract

Bruselloz özellikle ülkemizin doğu ve güneydoğu kesimlerinde endemik olarak görülen önemli bir enfeksiyon hastalığıdır. Bu makalede çocuklarda brusellozun klinik ve laboratuvar bulgularının ve tedavi sonuçlarının etkinliğini değerlendirmek amaçlandı.Eylül 2010 ile Şubat 2011 tarihleri arasında yaklaşık 6 aylık dönemde çocuk polikliniğine bruselloz düşündüren şikayetlerle başvuran çocuklar tetkik edildi. Tetkik edilen hastaların 43'üne bruselloz tanısı konuldu ve başvuru şikayetleri, fizik muayene bulguları ve laboratuvar sonuçları değerlendirildi. Olguların 22'si erkek (%51) olup ortalama yaşları 9.3 yaş (4 yaş-13 yaş) arasında idi. En sık başvuru yakınmaları; halsizlik olguların tamamı (%100), kas ağrısı olguların tamamı (%100) ve kilo kaybı (%86) idi. Olguların fizik muayenelerinde; artrit (%48), lenfadenopati (%6) ve splenomegali (%13) saptandı. Laboratuvar bulgularında olguların %51'inde sedimantasyon yüksekliği, %65'inde ALT/AST yüksekliği ve %72'sinde ise CRP pozitifliği vardı. Brusella aglütinasyon testleri olguların tamamında pozitifti. Kan kültüründe üreme olguların %6'sında tespit edildi. Olguların tamamına en az ikili antibiyotik tedavisi verildi. Rölaps %11 (n=5) oranında görüldü, mortalite gözlenmedi. Bruselloz özellikle hastalığın yaygın olduğu bölgelerde sağlık ekiplerinin üzerinde durması gereken ve koruyucu tedbirlerin alınması ve etkin tedavinin uygulanması gereken toplum sağlığı problemidir.

Keywords

Bruselloz; çocuk; laboratuvar bulguları; tedavi.

References

  • American Academy of Pediatrics. Brucellosis. In:Pickering LK, ed. 2009 Red Book: Report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics 2009;237-239.
  • Schutze GE, Jacobs RF. Brucella. In: Behrman RE, Kliegman RM, Jenson HB, ed. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: WB Saunders, 2004;939-941.
  • Hall WH. Brucellosis. In: Evans AS, Brachman PS, ed. Bacterial Infections of Humans. 2nd ed. New York: Plenum Publishing, 1991;133–151.
  • Young EJ. Brucella species. In: Mandell GL, Bennett JE, Dolin R, ed. Principles and Practice of Infectious Diseases. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Elsevier Churchill Livingstone, 2003;2669–2672. www.saglik.gov.tr/istatistikler (Erişim: Ekim 2010).
  • Palanduz A, Palanduz S, Guler N. Brucellosis in a mother and her young infant: probable transmission by breast milk. Int J Infect Dis 2000;4:55-6.
  • Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance. MMWR Recomm Rep 1997;46:1-55.
  • Alişkan H. The value of culture and serological methods in the diagnosis of human brucellosis. Mikrobiyol Bul 2008;42:1859
  • Celebi S, Hacımustafaoğlu M, Yılmaz E. Çocuklarda norobruselloz: uc vaka takdimi. Cocuk Sağlığı ve Hastalıkları Dergisi 2004;47:46-9.
  • Ragan VE. The Animal and Plant Health Inspection Service (APHIS) Brucellosis Eradication Program in the United States. Vet Microbiol 2002;90:11–8.
  • Buzgan T, Karahocagil MK, Irmak H, Baran AI, Karsen H, Evirgen O, et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis 2010;14:469-78.
  • Tanir G, Tufekci SB, Tuygun N. Presentation, complications, and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009;51:114-9.
  • Çelebi S, Hacımustafaoğlu M, Demirtaş F, Salı S, Gül Ü, Özel M. Çocukluk Çağında Brusello; J Pediatr Inf 2011;5:59-62.
  • Wallach JC, Miguel SE, Baldi PC, Guarnera E, Goldbaum FA, Fossati CA. Urban outbreak of a Brucella melitensis infection in an Argentine family: clinical and diagnostic aspects. FEMS Immunol Med Microbiol 1994;8:49- 56.
  • Abramson O, Rosenvasser Z, Block C, Dagan R. Detection and treatment of brucellosis by screening a population at risk. Pediatr Infect Dis J 1991;10:434-8.
  • Karadağ-Öncel E, Özsürekci Y, Cengiz AB, Kara A, Ceyhan M, Çelik M, ve ark. Çocukluk çağında bruselloz: Hacettepe Üniversitesi deneyimi; Çocuk Sağlığı ve Hastalıkları Dergisi 2011;54:135-41.
  • Shaalan MA, Memish ZA, Mahmoud SA, Alomari A, Khan MY, Almuneef M, et al. Brucellosis in children: clinical observations in 115 cases. Int J Infect Dis 2002;6:182–6.
  • Al-Eissa YA, Kambal AM, al-Nasser MN, al-Habib SA, alFawaz IM, al-Zamil FA. Childhood brucellosis: a study of 102 cases. Pediatr Infect Dis J 1990;9:74–9.
  • Shen MW. Diagnostic and therapeutic challenges of childhood brucellosis in a nonendemic country. Pediatrics 2008;121:11788
  • Secmeer G, Ecevit Z, Gulbulak B, Ceyhan M, Kanra G, Anlar Y. Splenic abscess due to brucella in childhood: a case report. Turk J Pediatr 1995;37:403-6.
  • Omar FZ, Zuberi S, Minns RA. Neurobrucellosis in childhood: six new cases and a review of the literature. Dev Med Child Neurol 1997;39:762-5.
  • Karakukcu M, Patıroğlu T, Ozdemir MA, Guneş T, Gumuş H, Karakukcu C. Pancytopenia, a rare hematologic manifestation of brucellosis in children. J Hematol Oncol 2004;26:803-6.
  • Shalev H, Abramson O, Levy J. Hematologic manifestations of brucellosis in children. Pediatr Infect Dis J 1994;13:543-5.
  • Gur E, Yildiz I, Celkan T, Can G, Akkus S, Arvas A, et al. Prevalence of anemia and the risk factors among school children in Istanbul. J Trop Pediatr 2005;51:346-50.
  • Yılmaz K, Bayraktaroğlu Z, Sivaslı E, Güler E, Balat A, Kılınç M, ve ark. Bruselloz tanılı çocuk hastalarda klinik ve laboratuvar verilerinin değerlendirilmesi. Çocuk Dergisi 2004;4:102-6.
  • Ariza J, Gudiol F, Pallares R, Viladrich PF, Rufi G, Corredoira J. Treatment of human brucellosis with doxycycline plus rifampin or doxycycline plus streptomycin: a randomized, double-blind study. Ann Intern Med 1992;117:25-30.
  • Agalar C, Usubutun S, Turkyilmaz R. Ciprofloxacin and rifampicin versus doxycycline and rifampicin in the treatment of brucellosis. Eur J Clin Microbiol Infect Dis 1999;18:535-8.
  • Palanduz A, Telhan l, Kadıoğlu LE, Erdem E, Ozturk AO. Çocukluk Çağında Bruselloz: 43 Olgunun Değerlendirilmesi. Cocuk Enfeksiyon Dergisi 2007;1:139-42.
  • Khuri-Bulos NA, Daoud AH, Azab SM. Treatment of childhood brucellosis: results of a prospective trial on 113 children. Pediatr Infect Dis J 1993;12:377–81.
  • Roushan MR, Mohraz M, Janmohammadi N, Hajiahmadi M. Efficacy of cotrimoxazole and rifampin for 6 or 8 weeks of therapy in childhood brucellosis. Pediatr Infect Dis J 2006;25:544-5.
  • Lubani MM, Dudin KI, Sharda DC, Ndhar DS, Araj GF, Hafez HA, et al. A multicenter therapeutic study of 1100 children with brucellosis. Pediatr Infect Dis J 1989;8:75–8.
  • Hall WH. Modern chemotherapy for brucellosis in humans. Rev Infect Dis 1990;12:1060-99.
There are 31 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Erdal Sarı This is me

İlkay Özgen Sarı This is me

Aysu Say This is me

Feray Güven This is me

Almala Pınar Ulutaş This is me

Publication Date February 1, 2013
Published in Issue Year 2013 Volume: 19 Issue: 1

Cite

APA Sarı, E., Sarı, İ. Ö., Say, A., Güven, F., et al. (2013). Türkiye’nin endemik bölgesi Van’da çocuk bruselloz hastalarının incelenmesi. Gaziantep Medical Journal, 19(1), 1-4. https://doi.org/10.5455/GMJ-30-2012-111
AMA Sarı E, Sarı İÖ, Say A, Güven F, Ulutaş AP. Türkiye’nin endemik bölgesi Van’da çocuk bruselloz hastalarının incelenmesi. Gaziantep Medical Journal. February 2013;19(1):1-4. doi:10.5455/GMJ-30-2012-111
Chicago Sarı, Erdal, İlkay Özgen Sarı, Aysu Say, Feray Güven, and Almala Pınar Ulutaş. “Türkiye’nin Endemik bölgesi Van’da çocuk Bruselloz hastalarının Incelenmesi”. Gaziantep Medical Journal 19, no. 1 (February 2013): 1-4. https://doi.org/10.5455/GMJ-30-2012-111.
EndNote Sarı E, Sarı İÖ, Say A, Güven F, Ulutaş AP (February 1, 2013) Türkiye’nin endemik bölgesi Van’da çocuk bruselloz hastalarının incelenmesi. Gaziantep Medical Journal 19 1 1–4.
IEEE E. Sarı, İ. Ö. Sarı, A. Say, F. Güven, and A. P. Ulutaş, “Türkiye’nin endemik bölgesi Van’da çocuk bruselloz hastalarının incelenmesi”, Gaziantep Medical Journal, vol. 19, no. 1, pp. 1–4, 2013, doi: 10.5455/GMJ-30-2012-111.
ISNAD Sarı, Erdal et al. “Türkiye’nin Endemik bölgesi Van’da çocuk Bruselloz hastalarının Incelenmesi”. Gaziantep Medical Journal 19/1 (February 2013), 1-4. https://doi.org/10.5455/GMJ-30-2012-111.
JAMA Sarı E, Sarı İÖ, Say A, Güven F, Ulutaş AP. Türkiye’nin endemik bölgesi Van’da çocuk bruselloz hastalarının incelenmesi. Gaziantep Medical Journal. 2013;19:1–4.
MLA Sarı, Erdal et al. “Türkiye’nin Endemik bölgesi Van’da çocuk Bruselloz hastalarının Incelenmesi”. Gaziantep Medical Journal, vol. 19, no. 1, 2013, pp. 1-4, doi:10.5455/GMJ-30-2012-111.
Vancouver Sarı E, Sarı İÖ, Say A, Güven F, Ulutaş AP. Türkiye’nin endemik bölgesi Van’da çocuk bruselloz hastalarının incelenmesi. Gaziantep Medical Journal. 2013;19(1):1-4.