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

Yıl 2025, Cilt: 47 Sayı: 5, 759 - 765, 04.09.2025
https://doi.org/10.20515/otd.1698284

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.

Kaynakça

  • 1. Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006;6(2):91–99.
  • 2. Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol. 2007;25(3):188–202.
  • 3. Al-Eissa YA. Brucellosis in children: clinical observations on 115 patients. Int J Infect Dis. 1999;3(1):41–45.
  • 4. Gür A, Geyik MF, Nas K, et al. Complications of brucellosis in different age groups: a study of 283 cases in southeastern Anatolia of Turkey. Yonsei Med J. 2003;44(1):33–44.
  • 5. Roushan MRH, Ebrahimpour S, Moulana Z. Epidemiological features and clinical manifestations of brucellosis: a retrospective study. Ann Trop Med Public Health. 2010;3(2):83–87.
  • 6. Akbayram S, Doğan M, Akgün C, et al. Clinical and laboratory presentation of childhood brucellosis. Turk J Pediatr. 2011;53(2):167–173.
  • 7. Solera J, Martinez-Alfaro E, Espinosa A. Recognition and optimum treatment of brucellosis. Drugs. 1997;53(2):245–256.
  • 8. Colmenero JD, Reguera JM, Martos F, et al. Complications associated with brucellosis: a study of 530 cases. Medicine (Baltimore). 1996;75(4):195–211.
  • 9. Young EJ. An overview of human brucellosis. Clin Infect Dis. 1995;21(2):283–289.
  • 10. El-Koumi MA, Afify M, Al-Zahrani SH. Clinical and hematological study of brucellosis in children: experience from a tertiary care hospital in Saudi Arabia. J Infect Dev Ctries. 2012;6(10):680–683.
  • 11. Lubani MM, Dudin KI, Sharda DC, et al. Neonatal brucellosis. Pediatr Infect Dis J. 1989;8(2):82–86.
  • 12. Memish ZA, Mah MW, Al Mahmoud S, et al. Brucella bacteremia: clinical and laboratory observations in 160 patients. J Infect. 2000;40(1):59–63.
  • 13. World Health Organization (WHO). Brucellosis in humans and animals. Geneva: WHO Press; 2006.
  • 14. Mantur BG, Biradar MS, Bidri RC, et al. Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years' experience in an endemic area. J Med Microbiol. 2006;55(7):897–903.
  • 15. Yagupsky P. Detection of Brucellae in blood cultures. J Clin Microbiol. 1999;37(11):3437–3442.
  • 16. Yılmaz H, Karaoğlan I, Namiduru M, Demirci M. Clinical and laboratory findings of brucellosis in Van, Turkey: a retrospective evaluation of 156 cases. J Infect Dev Ctries. 2013;7(10):777–781.
  • 17. Ulu-Kılıç A, Metan G, Alp E. Clinical presentations and diagnosis of brucellosis. Recent Pat Antiinfect Drug Discov. 2013;8(1):34–41.
  • 18. Solera J, Lozano E, Martinez-Alfaro E, et al. Brucellar spondylitis: review of 35 cases and literature survey. Clin Infect Dis. 1999;29(6):1440–1449.
  • 19. Ranjbar M, Shahabi S, Ebrahimpour S, et al. Epidemiological and clinical features of brucellosis in northern Iran: a review of 595 cases. Jpn J Infect Dis. 2013;66(4):312–316.
  • 20. Al Deeb SM, Yaqub BA, Sharif HS, Phadke JG. Neurobrucellosis: clinical characteristics, diagnosis, and outcome. Neurology. 1989;39(4):498–501.
  • 21. Shakir RA, Al-Din AS, Araj GF, et al. Clinical categories of neurobrucellosis. Brain. 1987;110(Pt 1):213–223.
  • 22. Aygen B, Doğanay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Mal Infect. 2002;32(8):485–493.
  • 23. Yılmaz E, Korkmaz MF, Uysal EB, et al. Clinical and epidemiological characteristics of pediatric brucellosis in southeastern Turkey: a 7-year experience. Turk J Pediatr Dis. 2018;12(3):175–181.
  • 24. Ulu-Kılıç A, Güneş T, Oğuz H, et al. An overview of pediatric brucellosis: a single-center retrospective study in an endemic area. J Microbiol Immunol Infect. 2017;50(1):121–125.
  • 25. Al-Eissa YA, Al-Fawaz IM, Al-Nasser MN, et al. Relapse rate of brucellosis in children. Int J Infect Dis. 1998;3(4):242–246.
  • 26. Solera J, Rodríguez-Zapata M, Geijo P, et al. Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. Clin Infect Dis. 1998;26(2):433–439.
  • 27. Colmenero JD, Jiménez-Mejías ME, Reguera JM, et al. Clinical findings, diagnostic approach and outcome of neurobrucellosis: a 16-year experience in a single institution. J Neurol Neurosurg Psychiatry. 1997;63(2):133–138.
  • 28. Yılmaz M, Yılmaz A, Gencer S, et al. Pediatric neurobrucellosis: report of five cases and review of the literature. Turk J Pediatr. 2010;52(6):625–630.

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

Yıl 2025, Cilt: 47 Sayı: 5, 759 - 765, 04.09.2025
https://doi.org/10.20515/otd.1698284

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.

Etik Beyan

Eklendi

Destekleyen Kurum

YOK

Kaynakça

  • 1. Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006;6(2):91–99.
  • 2. Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol. 2007;25(3):188–202.
  • 3. Al-Eissa YA. Brucellosis in children: clinical observations on 115 patients. Int J Infect Dis. 1999;3(1):41–45.
  • 4. Gür A, Geyik MF, Nas K, et al. Complications of brucellosis in different age groups: a study of 283 cases in southeastern Anatolia of Turkey. Yonsei Med J. 2003;44(1):33–44.
  • 5. Roushan MRH, Ebrahimpour S, Moulana Z. Epidemiological features and clinical manifestations of brucellosis: a retrospective study. Ann Trop Med Public Health. 2010;3(2):83–87.
  • 6. Akbayram S, Doğan M, Akgün C, et al. Clinical and laboratory presentation of childhood brucellosis. Turk J Pediatr. 2011;53(2):167–173.
  • 7. Solera J, Martinez-Alfaro E, Espinosa A. Recognition and optimum treatment of brucellosis. Drugs. 1997;53(2):245–256.
  • 8. Colmenero JD, Reguera JM, Martos F, et al. Complications associated with brucellosis: a study of 530 cases. Medicine (Baltimore). 1996;75(4):195–211.
  • 9. Young EJ. An overview of human brucellosis. Clin Infect Dis. 1995;21(2):283–289.
  • 10. El-Koumi MA, Afify M, Al-Zahrani SH. Clinical and hematological study of brucellosis in children: experience from a tertiary care hospital in Saudi Arabia. J Infect Dev Ctries. 2012;6(10):680–683.
  • 11. Lubani MM, Dudin KI, Sharda DC, et al. Neonatal brucellosis. Pediatr Infect Dis J. 1989;8(2):82–86.
  • 12. Memish ZA, Mah MW, Al Mahmoud S, et al. Brucella bacteremia: clinical and laboratory observations in 160 patients. J Infect. 2000;40(1):59–63.
  • 13. World Health Organization (WHO). Brucellosis in humans and animals. Geneva: WHO Press; 2006.
  • 14. Mantur BG, Biradar MS, Bidri RC, et al. Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years' experience in an endemic area. J Med Microbiol. 2006;55(7):897–903.
  • 15. Yagupsky P. Detection of Brucellae in blood cultures. J Clin Microbiol. 1999;37(11):3437–3442.
  • 16. Yılmaz H, Karaoğlan I, Namiduru M, Demirci M. Clinical and laboratory findings of brucellosis in Van, Turkey: a retrospective evaluation of 156 cases. J Infect Dev Ctries. 2013;7(10):777–781.
  • 17. Ulu-Kılıç A, Metan G, Alp E. Clinical presentations and diagnosis of brucellosis. Recent Pat Antiinfect Drug Discov. 2013;8(1):34–41.
  • 18. Solera J, Lozano E, Martinez-Alfaro E, et al. Brucellar spondylitis: review of 35 cases and literature survey. Clin Infect Dis. 1999;29(6):1440–1449.
  • 19. Ranjbar M, Shahabi S, Ebrahimpour S, et al. Epidemiological and clinical features of brucellosis in northern Iran: a review of 595 cases. Jpn J Infect Dis. 2013;66(4):312–316.
  • 20. Al Deeb SM, Yaqub BA, Sharif HS, Phadke JG. Neurobrucellosis: clinical characteristics, diagnosis, and outcome. Neurology. 1989;39(4):498–501.
  • 21. Shakir RA, Al-Din AS, Araj GF, et al. Clinical categories of neurobrucellosis. Brain. 1987;110(Pt 1):213–223.
  • 22. Aygen B, Doğanay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Mal Infect. 2002;32(8):485–493.
  • 23. Yılmaz E, Korkmaz MF, Uysal EB, et al. Clinical and epidemiological characteristics of pediatric brucellosis in southeastern Turkey: a 7-year experience. Turk J Pediatr Dis. 2018;12(3):175–181.
  • 24. Ulu-Kılıç A, Güneş T, Oğuz H, et al. An overview of pediatric brucellosis: a single-center retrospective study in an endemic area. J Microbiol Immunol Infect. 2017;50(1):121–125.
  • 25. Al-Eissa YA, Al-Fawaz IM, Al-Nasser MN, et al. Relapse rate of brucellosis in children. Int J Infect Dis. 1998;3(4):242–246.
  • 26. Solera J, Rodríguez-Zapata M, Geijo P, et al. Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. Clin Infect Dis. 1998;26(2):433–439.
  • 27. Colmenero JD, Jiménez-Mejías ME, Reguera JM, et al. Clinical findings, diagnostic approach and outcome of neurobrucellosis: a 16-year experience in a single institution. J Neurol Neurosurg Psychiatry. 1997;63(2):133–138.
  • 28. Yılmaz M, Yılmaz A, Gencer S, et al. Pediatric neurobrucellosis: report of five cases and review of the literature. Turk J Pediatr. 2010;52(6):625–630.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Çocuk Bulaşıcı Hastalıkları
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Berfin Özgökçe Özmen 0000-0001-5054-8507

Şefika Aldaş 0009-0006-9222-6163

Suna Özdem 0000-0002-8042-9119

Yayımlanma Tarihi 4 Eylül 2025
Gönderilme Tarihi 13 Mayıs 2025
Kabul Tarihi 16 Temmuz 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 5

Kaynak Göster

Vancouver Özgökçe Özmen B, Aldaş Ş, Özdem S. Çocuklarda Bruselloz: Üçüncü Basamak Bir Hastanede Tek Merkez Deneyimi ve Klinik Değerlendirme. Osmangazi Tıp Dergisi. 2025;47(5):759-65.


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