111 Bruselloz olgusunun etyoloji, klinik seyir ve komplikasyonlarının değerlendirilmesi; bir retrospektif çalışma

Year 2020, Volume: 13 Issue: 3, 339 - 347, 05.12.2020

Tuba Tatlı Kış Mehmet Kış Şükran Köse

https://doi.org/10.26559/mersinsbd.774799

Abstract

Amaç: Bruselloz dünyada en sık görülen bakteriyel zoonotik enfeksiyon hastalığıdır. Çalışmamızda hastalığın endemik olarak görüldüğü Güneydoğu Anadolu bölgesinde ikinci basamak bir hastaneye başvuran ve bruselloz tanısı ile takip edilen 111 bruselloz olgusunun değerlendirilmesi amaçlandı. Yöntem: Çalışmada ikinci basamak bir hastanenin Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji polikliniğine Aralık 2018 – Aralık 2019 tarihleri arasında başvuran bruselloz tanısı ile ayaktan veya yatarak takip edilen 111 olgunun demografik özellikleri, klinik bulguları, olası bulaş yolları, tedavi rejimleri, komplikasyon verileri ve relaps oranları retrospektif olarak incelendi. Bulgular: Hastaların 77’si (%69.3) kadın ve olguların yaş ortalaması 36.4 (yaş aralığı 14-94) idi. Meslek dağılımı açısından, hastaların 69’u (%62.1) ev hanımıydı, 17’si (%15.3) hayvancılıkla uğraşmaktaydı. Olguların 88’inde (%79.2) taze peynir yeme öyküsü vardı. Hastalarda en sık görülen semptomlar, halsizlik (%92.7) ve artralji (%87.3) olarak saptandı. Çalışmaya alınan hastalarda CRP yüksekliği %39.6, anemi %37.8 oranı ile en sık görülen laboratuvar bulguları olarak tespit edildi. Etkilenen organ ve sistemler incelendiğinde olguların 49’unda (%44) hematolojik tutulum, 23’ünde (%20.7) karaciğer tutulumu, 11’inde (%10) osteoartiküler tutulum görüldü. Bir (%0.9) hastada brusellozun nadir bir komplikasyonu olarak izole perikardit, bir (%0.9) hastada da brusella epididimoorşiti saptandı. Çalışmaya dahil edilen hastaların 12’sinde (%10.3) tedavileri bittikten sonraki bir yıllık izlemde relaps saptandı. Sonuç: Bruselloz birçok organ ve dokuyu etkileyebilmektedir. Bu nedenle çok değişik klinik belirti ve bulgularla ortaya çıkabilmekte ve birçok hastalıkla karışabilmektedir. Endemik bölgelerde yaşayan nonspesifik semptom ve bulgular ile başvuran hastalar mutlaka bruselloz açısından değerlendirilmelidir.

Keywords

bruselloz, epidemiyoloji, komplikasyon

Evaluation of etiology, clinical course and complications of 111 brucellosis cases; a retrospective study

Abstract

Aim: Brucellosis is the most common bacterial zoonotic infection disease in the world. In our study, we aimed to evaluate 111 brucellosis cases who were admitted to a secondary-line hospital by followed up with the diagnosis of brucellosis in the Southeastern Anatolia region where the disease was seen as endemic. Method: In this study, demographic characteristics, clinical findings, possible transmission routes, treatment regimens, complication data and relapse rates of 111 patients who were admitted to an infectious diseases and clinical microbiology clinic of a second-line hospital between December 2018 and December 2019 were examined retrospectively. Results: Seventy-seven of the patients (69.3%) were female and the mean age of the patients was 36.4 (age range 14-94). In terms of profession distribution, 69 (62.1%) of the patients were housewives, 17 (15.3%) of the patients were engaged in animal husbandry. There was a history of eating fresh cheese in 88 (79.2%) patients. The most common symptoms of the patients were malaise (92.7%) and arthralgia (87.3%). The most common laboratory findings in patients included in the study were 39.6% CRP elevation and 37.8% anemia. When the affected organs and systems are examined, hematological involvement was observed in 49 (44%) patients, liver involvement in 23 (20.7%) patients, osteoarticular involvement in 11 (10%) patients. There was found to one patient (0.9%) had isolated pericarditis that was a rare complication of brucellosis, and brucella epididymoorchitis in one (0.9%) patient. In the one-year follow-up after treatment, relapses were detected in 12 patients (10.3%). Conclusion: Brucellosis can affect many organs and tissues. For this reason, it can appear with many different clinical signs and symptoms and can be confused with many diseases. In patients presenting with nonspecific symptoms and signs, who were living in endemic regions, brucellosis infection should definitely be considered, and patients should be evaluated for brucellosis.

Keywords

Brucellosis, epidemiology, complication

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