Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization

Öz

Objective: Human brucellosis is a systemic disease that mimics many diseases, and its diagnosis is extremely difficult in children. Childhood brucellosis may present with serious clinical pictures and cause complications. This study aimed to investigate the characteristics of childhood brucellosis and the diagnostic role of laboratory markers for hospitalization. Material and Methods: Sixty children aged between 0 and 18 years who were diagnosed with brucellosis between January 1, 2018 and December 31, 2019 were evaluated retrospectively. The demographic characteristics and clinical, microbiological, and other laboratory findings of brucellosis patients who were followed up as outpatient and inpatient were examined. Results: The median age of the patients was 9.3±4.3 years; 41.7% were girls and 58.3% were boys. Joint involvement was 83.3% of the patients. Total 33.3% patients were hospitalized. The median value of blood serum eosinophil counts was 60/μL (10-90/μL) in hospitalized patients and 110/ μL (55-205/μL) in outpatients (p=0.022). For blood eosinophil count cutoff level ≤ 90/μL (confidence interval [CI] 95%, 54.4-93.9), sensitivity was 78.95% (Cl 95%, 54.4-93.9) and specificity was 60%, (Cl 95%, 43.3-75.1). Conclusion: Childhood brucellosis remains an important public health problem for our country. Blood eosinophil levels may have a role in indicating the degree of disease and deciding hospitalization in childhood brucellosis. New studies with more patients are needed to understand this relationship better and to evaluate its specificity and sensitivity.

Anahtar Kelimeler

• Brcellosis
• child
• blood eosinophil count

Çocukluk Çağı Bruselloz Özellikleri ve Hastaneye Yatışta Laboratuvar Belirteçlerinin Tanısal Rolü

Öz

Amaç: İnsan brusellozu, birçok hastalığı taklit eden sistemik bir hastalıktır ve çocuklarda da teşhis edilmesi çok zor olabilmektedir. Çocukluk çağı brusellozu, ciddi klinik tablolarla karşımıza gelebilir ve komplikasyonlara neden olabilir. Bu çalışmada, çocukluk çağı bruselloz hastalarının özellikleri ile hastaneye yatışta laboratuvar belirteçlerin tanısal rolünün araştırılması amaçlandı. Gereç ve Yöntemler: Geriye dönük olarak 1 Ocak 2018 ile 31 Aralık 2019 tarihleri arasında bruselloz tanısı alan 0-18 yaş 60 çocuk hasta değerlendirildi. Ayaktan ve hastaneye yatış verilerek izlenen bruselloz hastalarının demografik özellikleri ve klinikleri ile mikrobiyolojik ve diğer laboratuvar bulguları incelendi. Bulgular: Hastaların yaş ortalaması, 9.3±4.3 yıldı ve %41,7’si kız, %58,3’ü erkek idi. Hastaların %83,3’ünde eklem tutulumu mevcuttu. Hastaların %33,3’ü yatırılarak izlendi. Kan serum eozinofil sayıları yatan hastalarda ortanca değeri 60/μL (10-90/μL) iken ayaktan hastalarda 110/μL (55-205/ μL) değerleri arasında idi (p=0,022). Kan eozinofil sayısı kesme seviyesi ≤90/μL için; (CI %95, 54,4-93,9) duyarlılık %78,95 (Cl %95, 54,4-93,9) ve özgüllük %60,00, (Cl %95,43,3-75,1) olarak bulundu. Sonuç: Çocukluk çağı brusellozu ülkemiz için önemli bir halk sağlığı sorunu olmaya devam etmektedir. Kan eozinofil düzeyleri, çocukluk çağı brusellozunda hastalık derecesini göstermede ve yatışa karar vermede bir role sahip olabilir ama bu ilişkinin daha iyi anlaşılması, özgüllük ve duyarlılığının değerlendirmesi için daha fazla sayıda hasta ile yeni çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Bruselloz
• çocuk
• kan eozinofil sayısı

Kaynakça

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