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

Yıl 2023, Cilt: 50 Sayı: 4 - Cilt 50, Sayı 4, 461 - 469, 29.12.2023

Yeliz Çiçek , Nida Özcan Yakup Demir , Saim Dayan

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

Öz

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.

Anahtar Kelimeler

brucella capture, blood culture, complication.

Kaynakça

• 1.Altan N. Bruselloz epidemiyolojisi.1.Ulusalİnfeksiyon Hastalıkları Kongre Kitabı. İzmir, 20-23Nisan 1987:179-85.
• 2.Madkour MM. Bruselloz. İstanbul: Nobel TıpKitabevleri, 2008.
• 3.Kaya S. Brucellos ve Tedavi Sorunu İnfeksiyonDergisi (Turkish Journal of Infection). 20 (3): 227-230.2006.
• 4.Yumruk Z. Brucella Türleri. In: Willke Topçu A,Söyletir G, Doğanay M, Eds. İnfeksiyon Hastalıklarıve Mikrobiyolojisi. Ankara: Nobel Tıp Kitabevleri.2017:1956-61.
• 5.Doğanay M, Alp Meşe E. Bruselloz. In: WillkeTopçu A, Söyletir G, Doğanay M, Eds. İnfeksiyonHastalıkları ve Mikrobiyolojisi. 4. Baskı, Ankara:Nobel Tıp Kitabevleri. 2017:863-72.
• 6.Baysal B. Brucella. In: Mutlu G, İmir T, Cengiz AT,et al. Temel ve Klinik Mikrobiyoloji. . Ankara: GüneşKitabevi. 1999:571-7.
• 7.Ural O. Bruselloz: Özel vakalarda tedavi sorunları.Klimik Dergisi. 2005; 18(1):106-8.
• 8.Mantur BG, Akki AS, Mangalgi SS, et al. Childhoodbrusellozis-a microbiological, epidemiological andclinical study. J Trop Pediatr. 2004; 50:153-7.
• 9.Ataman-Hatipoğlu Ç, Kınıklı S, Tülek N, ve ark. Bireğitim hastanesinin infeksiyon hastalıkları ve klinikmikrobiyoloji kliniğinde izlenen 202 brusellozolgusunun epidemiyolojik verilerinin irdelenmesi.Klimik Dergisi. 2005; 18(3):94-8.
• 10.Edward JY. Brucella species. In: Mandell GL,Douglas RG, Bennet JE, (Editors). Principles andPractice of Infectious Diseases. 7th Edition,Philedelphia: Churchill Livingstone. 2010: 2921-5.
• 11.Young EJ. An overview of human brusellozis. Clin Infect Dis. 1995; 21:283-90.
• 12.Tasova Y., N. Saltoglu G. Sahin And H. S. Aksu.Osteoarthricular İnvolvement Of Brucellosis İnTurkey. Clin. Rheumatol. 18:214–219. 1999.
• 13.Gürsoy B, Tekin-Koruk S, Sırmatel F, Karaağaç L.Bruselloz: 140 Olgunun Değerlendirilmesi. KlimikDergisi. 2008, 21: 101-104. 97.
• 14.Tansel Ö, Yavuz M, Kuloğlu F, Akata F. TrakyaÜniversitesi Hastanesi’ne başvuran 40 brusellozolgusunun değerlendirilmesi. İnfeksiyon Dergisi(Turk J Infect.). 2003; 17(1):1-4.
• 15.Saçar S, Cenger Hırçın D, Toprak S, Demir M,Turgut H. Otuz bruselloz olgusunun klinikdeğerlendirilmesi. İnfeksiyon Dergisi (Turk J Infect.)2008; 22(1):11-4.
• 16. Gül CH, Coşkun Ö, Turhan V, ve ark Bruselloz:140olgunun geriye dönük olarak irdelenmesi. TSKKoruyucu Hekimlik Bülteni. 2007; 6(4):249-52.
• 17.Ertek M, Yazgı H, Kadanalı A, Özden K, TaşyaranMA. Complications of Brucella Infection amongadults: An 18 year retrospective evaluation. Turk JMed Sci. 2006; 36(6):377-81.
• 18.Çağatay AA, Küçükoğlu S, Berk H, et al. Otuz altıbruselloz olgusunun değerlendirilmesi. KlimikDergisi. 2002; 15(1):19-21.
• 19.Palanduz A, Telhan L, Kadıoğlu LE, Erdem E,Öztürk AO. Çocukluk çağında bruselloz:43 olgunundeğerlendirilmesi. Çocuk Enf Derg. 2007; 1:139-42.
• 20.Shaalan MA, Memish ZA, Mahmoud SA, et al.Brusellozis in children: clinical observations in 115cases. Int J Infec Dis. 2002; 6:182-186.
• 21.Galanakis E, Bourantas KL, Leveidiotou S,Lapatsanis PD. Childhood brusellozis in North- western Greece: a retrospective analysis. Eur JPediatr. 1996; 155:1-6.
• 22.Geyik MF, Kökoğlu ÖF, Hoşoğlu S, Ayaz C.Brusellozlu 154 hastanın değerlendirilmesi. DicleTıp Dergisi (Journal of Dicle Medical School). 2002;29(1):23-9.
• 23.Tanir G, Tufekci SB, Tuygun N. Presentation,complication, and treatment outcome of brusellozisin Turkish children. Pediatrics International. 2009;51:114-9.
• 24.Bulut İK, Bulut MO, Büyükayhan D, ve ark.Çocukluk çağında bruselloz: Takip edilen olgularınincelenmesi. C. Ü. Tıp Fakültesi Dergisi. 2005;27(4):133-6.
• 25.Ertek M, Yazgı H, Kadanalı A, Özden K, TaşyaranMA. Complications of Brucella Infection amongadults: An 18 year retrospective evaluation. Turk JMed Sci. 2006; 36(6):377-81.
• 26.Yüce A, Alp-Çavuş S. Türkiye’de Bruselloz: Genelbakış Klimik Dergisi. 2006; 19(3):87-97
• 27.Buzgan T, Karahocagil MK, Irmak H, et al. Clinicalmanifestations and complications in 1028 cases ofbrusellozis: a retrospective evaluation and review of the literature. Int J Infect Dis. 2010; 14:469-78.
• 28.Kaya O, Akçam FZ, Avşar K, Tığlı A, Yaylı G.Bruselloz:75 olgunun klinik ve laboratuvarverilerinin değerlendirilmesi. Turkiye Klinikleri J Med Sci. 2006; 26:623-9.
• 29.Gür A, Geyik MF, Dikici B, et al. Complications ofbrusellozis in different age groups: A study of 283cases in Southeastern Anatolia of Turkey. YonseiMedical Journal. 2003; 44(1):33-44.
• 30.Kaya S. 44 Bruselloz olgusunundeğerlendirilmesi. Klimik Dergisi. 2007; 20(1):17-9.
• 31. Gul HC., Erdem H. Brucella species, In: Bennett JE, Dolin R, Blaser JM: (eds), Principles and Practice ofInfectious Diseases. 9th ed. Philadelphia, 2019; 2:2753-7.
• 32.Erdem H, Elaldi N, Batirel A, et al. Comparison ofbrucellar and tuberculous spondylodiscitis patients: results of the multicenter “backbone-1 study. SpineJ.2015;15:2509–17.
• 33.Erdem H, Elaldi N, Ak O, et al. Genitourinarybrucellosis: results of a multicentric study. ClinMicrobiol Infect. 2014;20:O847–53.
• 34.Bosilkovski M, Krteva L, Dimzova M, Kondova I.Brucellosis in 418 patients from the BalkanPeninsula: exposure-related differences in clinicalmanifestations, laboratory test results, and therapyoutcome. Int J Infect Dis. 2007;11:342–7.
• 35.Ariza J, Servitje O, Pallarés R, et al. Characteristiccutaneous lesions in patients with brucellosis. ArchDermatol. 1989;125:380–3.
• 36.Calik S, Gokengin AD. Human brucellosis inTurkey: a review of the literature between 1990 and2009. Turk J Med Sci. 2011;41:549–55.
• 37.Schey KL, Luther JM, Rose KL Human brucellosisand adverse pregnancy outcomes. 2016; 3: 1–21.