Eighty-three cases of brucella infection from an endemic region

Yıl 2019, Cilt: 11 Sayı: 2, 101 - 106, 01.06.2019

Meyha Şahin Selcan Cesur Serkan Enki

https://doi.org/10.21601/ortadogutipdergisi.543853

Öz

Aim: Brucellosis is the most common bacterial zoonosis
in all around the world and still a public health threat with high rates of incidence
in Turkey. In the present study, we evaluated the brucella infection cases, manifested
in Sirnak, one of the regions that brucellosis is common in our country.

Materials and Methods: We retrospectively collected data of 83 outpatients
and inpatients who admitted infectious disease department of a second-line hospital
between dates of October 2017 and December 2018. We have evaluated possible risk
factors for brucellosis, complaints of the patients, the initiation time of the
complaints, clinical signs, complications and treatment regimes.

Results: 61.4% (51/83) of the patients included in the
study were female. The mean age of the patients was 35.3 (15-84). Brucella infection
was most common among housewives (39.7%) and the most common risk factor was fresh
dairy cheese consumption (78.3%). The most common symptom was muscle and joint pain.
We have applied 13 different treatment regimens in the form of double and triple
drug combinations, and treatment of 13.2% of the patients was switched because of
various reasons. 30.1% of the patients infected with brucella had hepatitis and
13.2% had osteoarticular involvement. Erythrocyte sedimentation rate (p = 0.009)
and C reactive protein (p = 0.046) were statistically significant high in patients
with osteoarticular involvement compared to without. The correlation between higher
Erythrocyte sedimentation rate (p = 0.009), C reactive protein (p = 0.046) values
and osteoarticular involvement was statistically significant. Epididymoorchitis
was developed in three patients (3,6%). The rate of relapse was 26.5%.

Conclusion: Brucella infection should be kept in mind in
patients presenting with nonspecific symptoms, especially in areas where brucella
infection is common like our region and patients should be examined for brucellosis.

Anahtar Kelimeler

Brucellosis, complications, relapse

Endemik olduğu bir bölgeden 83 olgu ile brusella enfeksiyonu

Öz

Amaç: Brusella enfeksiyonu; dünya genelindeki en
yaygın bakteriyel zoonoz olup ülkemizde de yüksek görülme oranları ile bir halk
sağlığı sorunu olmaya devam etmektedir. Biz de çalışmamızda brusellozun ülkemizde
sık görüldüğü bölgelerden biri olan Şırnak ilindeki olguları irdeledik.

Gereç ve Yöntem: İkinci basamak bir hastanenin enfeksiyon hastalıkları
ve klinik mikrobiyoloji polikliğine Ekim 2017- Aralık 2018 tarihleri arasında başvuran,
ayaktan ve yatarak takip edilen 83 brusella ile enfekte hastanın olası risk faktörleri,
başvuru şikayetleri, şikayetlerin başlama zamanı, klinik bulguları, gelişen komplikasyonları
ve başlanan tedavileri retrospektif olarak incelendi.

Bulgular: Çalışmaya alınan 83 hastanın %61,4’ü (51/83)
kadındı. Hastaların yaş ortalaması 35,3 (15-84) saptandı. Brusella enfeksiyonuna
en çok ev hanımlarında rastlandı (%39,7) ve en yaygın risk faktörü taze peynir tüketimi
idi (%78,3). En sık görülen semptom ise yaygın kas ve eklem ağrısı idi. İkili ve
üçlü kombinasyonlar şeklinde 13 farklı tedavi rejimi uygulandı, hastaların %13,2’sinde
çeşitli nedenlerle tedavi değişikliği yapıldı. Brusella ile enfekte hastaların %30,1’inde
hepatit, %13,2’sinde kemik eklem tutulumu saptandı. Osteoartiküler tutulumu olanlarda;
eritrosit sedimantasyon hızı (p=0,009) ve C reaktif protein (p=0,046) yüksekliği,
olmayanlara göre istatistiksel olarak anlamlı saptandı. Üç hastada (%3,6) ise epididmoorşit
gelişmişti. Hastaların %26,5’inde relaps görüldü.

Sonuç: Özellikle bölgemiz gibi brusella enfeksiyonunun
yaygın olarak görüldüğü yerlerde nonspesifik semptom ve bulgular ile başvuran hastalarda
mutlaka brusella enfeksiyonu akılda tutulmalı ve hastalar bruselloz açısından tetkik
edilmelidir.

Anahtar Kelimeler

Bruselloz, komplikasyonlar, relaps

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