Brucellosis in Children: A Single-Center Experience and Clinical Evaluation in A Tertiary Care Hospital

Öz

Brucellosis is a prevalent zoonotic disease in childhood, particularly in endemic regions. This study aimed to compare the clinical, laboratory, and serological features of bacteremic and non-bacteremic pediatric brucellosis patients.This retrospective study included 117 pediatric patients diagnosed with brucellosis between February 2017 and July 2024. Patients were classified into bacteremic (n=38) and non-bacteremic (n=79) groups according to blood culture results. Statistical analyses were performed using R version 4.5.0. Normality of continuous variables was assessed using the Shapiro–Wilk test. The independent samples t-test was used for normally distributed variables, and the Wilcoxon rank-sum test for non-normal distributions. Categorical variables were compared using the Pearson Chi-square or Fisher’s exact test, as appropriate. A p-value of <0.05 was considered statistically significant.Hospitalization was significantly more common in the bacteremic group (39.5%) than in the non-bacteremic group (11.4%) (p = 0.001), and hospital stay distribution also differed between groups (p = 0.035). Splenomegaly (p = 0.004) and arthritis (p = 0.001) were more frequently observed in the non-bacteremic group. Laboratory analyses revealed significantly lower hemoglobin (p = 0.037) and MPV (mean platelet volume) (p = 0.048) levels in bacteremic patients. No significant differences were found in CRP, ESR, WBC counts, or serological test results.Bacteremic pediatric brucellosis cases may present with fewer localized symptoms but require longer hospitalization. Reduced hemoglobin and MPV values may serve as potential indicators of bacteremia. These findings contribute to the understanding of the clinical variability of pediatric brucellosis and support early risk stratification.

Anahtar Kelimeler

• Brucellosis
• childhood
• Brucella melitensis
• blood culture
• zoonotic infection

Çocuklarda Bruselloz: Üçüncü Basamak Bir Hastanede Tek Merkez Deneyimi ve Klinik Değerlendirme

Öz

Bruselloz, çocukluk çağında endemik bölgelerde sık görülen önemli bir zoonotik enfeksiyondur. Bu çalışmada, bakteriyemik ve bakteriyemik olmayan çocukluk çağı bruselloz olgularının klinik, laboratuvar ve serolojik özelliklerinin karşılaştırılması amaçlanmıştır.Bu retrospektif çalışmada, Şubat 2017 - Temmuz 2024 tarihleri arasında bruselloz tanısı almış 117 çocuk hasta değerlendirildi. Hastalar, kan kültürü sonucuna göre bakteriyemik (n=38) ve bakteriyemik olmayan (n=79) olarak iki gruba ayrıldı. Verilerin analizinde R versiyon 4.5.0 yazılımı kullanıldı. Sürekli değişkenlerde normallik dağılımı Shapiro–Wilk testi ile değerlendirildi. İkili karşılaştırmalarda parametrik veriler için bağımsız gruplar t-testi, parametrik olmayanlar için Wilcoxon testi kullanıldı. Kategorik değişkenlerde Pearson ki-kare veya Fisher exact testleri uygulandı. p<0,05 anlamlı kabul edildi.Bakteriyemik hastalarda hastaneye yatış oranı (%39,5), bakteriyemik olmayanlara göre (%11,4) anlamlı olarak yüksekti (p=0,001). Yatış süresi dağılımı da gruplar arasında farklıydı (p=0,035). Splenomegali (p=0,004) ve artrit (p=0,001), bakteriyemik olmayan grupta daha sık görüldü. Laboratuvar bulgularında, bakteriyemik grupta hemoglobin düzeyi (p=0,037) ve MPV (ortalama trombosit hacmi) (p=0,048) anlamlı olarak daha düşüktü. CRP, ESR, WBC ve serolojik test sonuçlarında gruplar arasında anlamlı fark saptanmadı.Bakteriyemik çocukluk çağı bruselloz olgularında lokal bulgular daha az izlenmekte ancak hastaneye yatış ihtiyacı daha fazla olmaktadır. Düşük hemoglobin ve MPV değerleri, bakteriyeminin olası göstergeleri olarak düşünülebilir. Elde edilen bulgular, çocukluk çağı brusellozunun klinik çeşitliliğine ışık tutmakta ve erken risk sınıflaması açısından katkı sağlamaktadır.

Anahtar Kelimeler

• Bruselloz
• çocukluk çağı
• Brucella melitensis
• kan kültürü
• zoonotik enfeksiyon

Kaynakça

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