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Çocukluk çağında bruselloz: 37 olgunun retrospektif değerlendirilmesi ve literatürün gözden geçirilmesi

Year 2022, Volume: 7 Issue: 3, 84 - 91, 31.07.2022

Taylan Çelik Emre Kaan

https://doi.org/10.22391/fppc.1035377

Abstract

Giriş: Bu çalışmada, kliniğimizde bruselloz tanısıyla takip edilen hastaların demografik, klinik, laboratuvar özellikleri ve tedavi sonuçlarını değerlendirmeyi amaçladık.

Yöntem: Kayseri Eğitim ve Araştırma Hastanesi, Çocuk Enfeksiyon Hastalıkları Kliniği’nde Ekim 2016-Aralık 2018 tarihleri arasında bruselloz tanısıyla takip edilen hastalar retrospektif olarak incelendi.

Bulgular: Çalışmaya 26’sı (%70.3) erkek toplam 37 hasta alındı. Yaşları 1 ile 17 arasında değişen hastaların yaş ortalaması 9.3±4.3 yıldı. Hastaların %86.5’inde pastörize edilmemiş süt ve/veya süt ürünü tüketimi, %67.6’sında ailede hayvancılık ve %48.6’sında da ailede bruselloz öyküsü vardı. Eklem ağrısı (%75.7) en sık başvuru yakınması olarak saptandı. Laboratuvar değerlendirilmesinde hastaların %8.1’inde lökopeni, %2.7’inde trombositopeni ve %21.4’ünde ALT yüksekliği vardı. Tedavide doksisiklin artı rifampisin (%43.2) en sık tercih edilen rejimdi. Hastanede yatan hastalarda başlangıç tedavisine aminoglikozid eklenmesi, ayaktan hastalara göre istatistiksel olarak daha yüksekti (%81.2'ye karşı %23.8) (p=0.001). Takipte 3’ü ayaktan takip edilen olgular olmak üzere toplam 4 (%10.8) hastada relaps gelişti. Başlangıç tedavi rejimi ile relaps arasında istatistiksel bir ilişki yoktu (p=0,418).

Sonuç: Sonuç olarak, ülkemizde eklem ağrısı yakınmasıyla başvuran tetkiklerinde sitopeni ve/veya izole aminotransferaz yüksekliği saptanan hastalarda bruselloz ayırıcı tanılar açısından akılda tutulmalıdır.

Anahtar kelimeler: Çocuk, Bruselloz, Relaps

Keywords

Çocuk Bruselloz Lökopeni Relaps Trombositopeni

References

  • 1. Arslan Kara A, Ozen M. Brucellosis. In:Cokugras H, (eds). Infectious Diseases in Children. Selen Publishing. 1st ed. 2015;255-62.
  • 2. Keser Emiroglu M, Salman N. Brucellosis. In:Somer A, Salman N, Yalcin I (eds). Pediatric Infectious Diseases. Istanbul Medical Bookstores. 3rd ed. 2018;349-54.
  • 3. American Academy of Pediatrics. Brucellosis. In: Red Book, Kimberlin DW, Brady MT, Jackson MA, Long SS (eds). Red Book: Report of the Committee on Infectious Diseases. 31st ed. 2018;841-44.
  • 4. Arslan Kara A, Ozen M. Current Approach to Brucella Infections. In: Somer A, Kara A, Ciftci E, Tezer H (eds.). Current Approaches to Childhood Infections. Selen Publishing. 1st ed. 2017;403-11.
  • 5. Young EJ. Brucellosis. In: Cherry JD, Harrison GJ, Kaplan SL, Steimnbach WJ, Hotez BJ, (eds). Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. Elsevier. 2019;1156-8
  • 6. Bukhari EE. Pediatric Brucellosis. An update review for the new millennium. Saudi Med J, 2018;39(4):336-41. https://doi.org/10.15537/smj.2018.4.21896
  • 7. Ozcanaslan FC, Cay U, Ozgur Gundeslioglu O, Unal I, Kocabas E. Retrospective evaluation of pediatric brucella patients followed and family screening with household members for brucella infection. J Pediatr Inf 2021;15(2):73-8. https://doi.org/10.5578/ced.202119801
  • 8. Catakli T, Kilic N, Dallar Y. Thirty-three patient with brucellosis evaluated retrospectively. Ege J Med 2011;50(1):39-42.
  • 9. Celebi S, Hacimustafaoglu M, Demirtas F, Sali E, Gul U, Ozel M. Brucellosis in childhood. J pediatr Inf, 2011;5:59-62. https://doi.org/10.5152/ced.2011.23
  • 10. Karadag-Oncel E, Ozsurekci Y, Cengiz AB, Kara A, Ceyhan M, Celik M, et al. Childhood brucellosis: Hacettepe University experience. Cocuk Sagligi ve Hastaliklari Dergisi, 2011;54:135-41.
  • 11. Abuhandan M, Guzel B, Cakmak A, Cicek A. Pediatric brucellosis: a retrospective evaluation of 82 cases. J Pediatr Inf, 2012;6(3):74-9. https://doi.org/10.5152/ced.2012.24
  • 12. Ulug M, Yaman Y, Yapici F, Can-Ulug N. Clinical and laboratory features, complications and treatment outcome of brucellosis in childhood and review of the literature. Turk J Pediatr 2011;53(4):413-24.
  • 13. Okur M, Erbey F, Bektas MS, Kaya A, Dogan M, Acar MN, Uzun H. Retrospective clinical and laboratory evaluation of children with brucellosis. Pediatr Int 2012;54(2):215-8. https://doi.org/10.1111/j.1442-200X.2011.03558.x
  • 14. Yoldas T, Tezer H, Ozkaya-Parlakay A, Sayili TR. Clinical and laboratory findings of 97 pediatric brucellosis patients in central Turkey. J Microbiol Immunol Infect 2015;48(4):446-9. https://doi.org/10.1016/j.jmii.2014.04.016
  • 15. Parlak M, Akbayram S, Dogan M, Tuncer O, Bayram Y, Ceylan N, Oner A. Clinical manifestations and laboratory findings of 496 children with brucellosis in Van, Turkey. Pediatr Int 2015;57(4):586-9. https://doi.org/10.1111/ped.12598
  • 16. Cirakli S, Karli A, Sensoy G, Belet N, Yanik K, Cirakli A. Evaluation of childhood brucellosis in the central Black Sea region. Turk J Pediatr 2015;57:123-8.
  • 17. Kara S, Aslan M, Volkan B, Ozel M, Fettah A. Retrospective evaluation of 94 pediatric patients with brucellosis diagnosis. Kocatepe Med J 2016;17(2):60-5. https://doi.org/10.18229/ktd.14381
  • 18. Bozdemir SE, Altıntop YA, Uytun S, Aslaner H, Torun YA. Diagnostic role of mean platelet volume and neutrophil to lymphocyte ratio in childhood brucellosis. Korean J Intern Med, 2017;32(6):1075. https://doi.org/10.3904/kjim.2016.092
  • 19. Yuksek SK, Gulhan B. Brucellosis in childhood: a single center experience. Turkish J Pediatr Dis, 2019;13(6);435-41.
  • 20. Gundeslioglu OO. Brucella infection in children: Evaluation of 148 pediatric patients. J Clin Anal Med 2018; https://doi.org/10.4328/JCAM.5956
  • 21. Buyukcam A. Features of childhood brucellosis and the diagnostic role of laboratory markers in hospitalization. J Child, 2020;20(3);89-95.
  • 22. Ciftdoğan DY, Aslan S. Osteoarticular involvement of brucellosis in pediatric patients: clinical and laboratory characteristics. Turk J Pediatr, 2020;62(2):199-207. https://doi.org/10.24953/turkjped.2020.02.005
  • 23. Bayhan GI, Batur A, Ece I. Pulmonary infections due to brucellosis in childhood. Tuberk Toraks, 2020;68(1):43. https://doi.org/10.5578/tt.69015
  • 24. Karaman S, Bitkin E, Sonmez B, Basaranoglu M, Karaman K, Tuncer O. Clinical and laboratory findings of paediatric patients with brucellosis. Meandros Med Dent J, 2021;22:63-8. https://doi.org/10.4274/meandros.galenos.2021.94809
  • 25. Pourakbari B, Abdolsalehi M, Mahmoudi S, Banar M, Masoumpour F, Mamishi S. Epidemiologic, clinical, and laboratory characteristics of childhood brucellosis: A study in an Iranian children's referral hospital. Wien Med Wochenschr, 2019;169(9):232-9. https://doi.org/10.1007/s10354-019-0685-z
  • 26. Ma L, Ma J, Chen X, Dong L. A 10-year retrospective comparative analysis of the clinical features of brucellosis in children and adults. J Infect Dev Ctries, 2021;15(08):1147-54. https://doi.org/10.3855/jidc.13962
  • 27. Hassouneh L, Quadri S, Pichilingue-Reto P, Chaisavaneeyakorn S, Cutrell JB, Wetzel DM, et al. An outbreak of brucellosis: an adult and pediatric case series. Open Forum Infec Dis, 2019;6(10):ofz384. https://doi.org/10.1093/ofid/ofz384
  • 28. Serpa JA, Knights S, Farmakiotis D, Campbell J. Brucellosis in adults and children: a 10-year case series at two large academic hospitals in Houston, Texas. South Med J, 2018;111(6):324-7. https://doi.org/10.14423/SMJ.0000000000000810
  • 29. Justman N, Fruchtman Y, Greenberg D, Ben-Shimol S. Hematologic manifestations of brucellosis in children. Pediatr Infect Dis J, 2018;37(6):586-91. https://doi.org/10.1097/INF.0000000000001900

Brucellosis in childhood: retrospective evaluation of 37 cases and review of the literature

Year 2022, Volume: 7 Issue: 3, 84 - 91, 31.07.2022

Taylan Çelik Emre Kaan

https://doi.org/10.22391/fppc.1035377

Abstract

Introduction: The aim of this study is to evaluate the demographic, clinical and laboratory characteristics and treatment results of pediatric patients followed up with the diagnosis of brucellosis in our clinic.

Methods: Patients who were followed up with the diagnosis of brucellosis in Kayseri Training and Research Hospital, Pediatric Infectious Diseases Clinic between October 2016 and December 2018 were retrospectively analyzed.

Results: A total of 37 patients, 26 (70.3%) male, were included in the study. The mean age of the patients whose ages ranged from 1 to 17 years was 9.3±4.3 years. Unpasteurized milk and/or dairy products were consumed in 86.5% of the patients and 48.6% had a family history of brucellosis. Joint pain (75.7%) was the most common presenting complaint. In the laboratory evaluation, 8.1% of the patients had leukopenia, 2.7% had thrombocytopenia and 21.4% had ALT elevation. Doxycycline plus rifampicin (43.2%) was the most commonly preferred treatment regimen. Addition of aminoglycoside to initial therapy in hospitalized patients was statistically higher than in outpatients (81.2% vs. 23.8%) (p=0.001). During the follow-up, relapse developed in a total of 4 (10.8%) patients, 3 of whom were outpatients. There was no statistical relationship between the initial treatment regimen and relapse (p=0.418).

Conclusion: In conclusion, brucellosis should be kept in mind in terms of differential diagnosis in patients who present with joint pain in our country and who have cytopenia and/or isolated aminotransferase elevation in their investigations.

Keywords: Child, Brucellosis, Relapse

Keywords

Child Brucellosis Leukopenia Relapse Thrombocytopenia

References

  • 1. Arslan Kara A, Ozen M. Brucellosis. In:Cokugras H, (eds). Infectious Diseases in Children. Selen Publishing. 1st ed. 2015;255-62.
  • 2. Keser Emiroglu M, Salman N. Brucellosis. In:Somer A, Salman N, Yalcin I (eds). Pediatric Infectious Diseases. Istanbul Medical Bookstores. 3rd ed. 2018;349-54.
  • 3. American Academy of Pediatrics. Brucellosis. In: Red Book, Kimberlin DW, Brady MT, Jackson MA, Long SS (eds). Red Book: Report of the Committee on Infectious Diseases. 31st ed. 2018;841-44.
  • 4. Arslan Kara A, Ozen M. Current Approach to Brucella Infections. In: Somer A, Kara A, Ciftci E, Tezer H (eds.). Current Approaches to Childhood Infections. Selen Publishing. 1st ed. 2017;403-11.
  • 5. Young EJ. Brucellosis. In: Cherry JD, Harrison GJ, Kaplan SL, Steimnbach WJ, Hotez BJ, (eds). Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. Elsevier. 2019;1156-8
  • 6. Bukhari EE. Pediatric Brucellosis. An update review for the new millennium. Saudi Med J, 2018;39(4):336-41. https://doi.org/10.15537/smj.2018.4.21896
  • 7. Ozcanaslan FC, Cay U, Ozgur Gundeslioglu O, Unal I, Kocabas E. Retrospective evaluation of pediatric brucella patients followed and family screening with household members for brucella infection. J Pediatr Inf 2021;15(2):73-8. https://doi.org/10.5578/ced.202119801
  • 8. Catakli T, Kilic N, Dallar Y. Thirty-three patient with brucellosis evaluated retrospectively. Ege J Med 2011;50(1):39-42.
  • 9. Celebi S, Hacimustafaoglu M, Demirtas F, Sali E, Gul U, Ozel M. Brucellosis in childhood. J pediatr Inf, 2011;5:59-62. https://doi.org/10.5152/ced.2011.23
  • 10. Karadag-Oncel E, Ozsurekci Y, Cengiz AB, Kara A, Ceyhan M, Celik M, et al. Childhood brucellosis: Hacettepe University experience. Cocuk Sagligi ve Hastaliklari Dergisi, 2011;54:135-41.
  • 11. Abuhandan M, Guzel B, Cakmak A, Cicek A. Pediatric brucellosis: a retrospective evaluation of 82 cases. J Pediatr Inf, 2012;6(3):74-9. https://doi.org/10.5152/ced.2012.24
  • 12. Ulug M, Yaman Y, Yapici F, Can-Ulug N. Clinical and laboratory features, complications and treatment outcome of brucellosis in childhood and review of the literature. Turk J Pediatr 2011;53(4):413-24.
  • 13. Okur M, Erbey F, Bektas MS, Kaya A, Dogan M, Acar MN, Uzun H. Retrospective clinical and laboratory evaluation of children with brucellosis. Pediatr Int 2012;54(2):215-8. https://doi.org/10.1111/j.1442-200X.2011.03558.x
  • 14. Yoldas T, Tezer H, Ozkaya-Parlakay A, Sayili TR. Clinical and laboratory findings of 97 pediatric brucellosis patients in central Turkey. J Microbiol Immunol Infect 2015;48(4):446-9. https://doi.org/10.1016/j.jmii.2014.04.016
  • 15. Parlak M, Akbayram S, Dogan M, Tuncer O, Bayram Y, Ceylan N, Oner A. Clinical manifestations and laboratory findings of 496 children with brucellosis in Van, Turkey. Pediatr Int 2015;57(4):586-9. https://doi.org/10.1111/ped.12598
  • 16. Cirakli S, Karli A, Sensoy G, Belet N, Yanik K, Cirakli A. Evaluation of childhood brucellosis in the central Black Sea region. Turk J Pediatr 2015;57:123-8.
  • 17. Kara S, Aslan M, Volkan B, Ozel M, Fettah A. Retrospective evaluation of 94 pediatric patients with brucellosis diagnosis. Kocatepe Med J 2016;17(2):60-5. https://doi.org/10.18229/ktd.14381
  • 18. Bozdemir SE, Altıntop YA, Uytun S, Aslaner H, Torun YA. Diagnostic role of mean platelet volume and neutrophil to lymphocyte ratio in childhood brucellosis. Korean J Intern Med, 2017;32(6):1075. https://doi.org/10.3904/kjim.2016.092
  • 19. Yuksek SK, Gulhan B. Brucellosis in childhood: a single center experience. Turkish J Pediatr Dis, 2019;13(6);435-41.
  • 20. Gundeslioglu OO. Brucella infection in children: Evaluation of 148 pediatric patients. J Clin Anal Med 2018; https://doi.org/10.4328/JCAM.5956
  • 21. Buyukcam A. Features of childhood brucellosis and the diagnostic role of laboratory markers in hospitalization. J Child, 2020;20(3);89-95.
  • 22. Ciftdoğan DY, Aslan S. Osteoarticular involvement of brucellosis in pediatric patients: clinical and laboratory characteristics. Turk J Pediatr, 2020;62(2):199-207. https://doi.org/10.24953/turkjped.2020.02.005
  • 23. Bayhan GI, Batur A, Ece I. Pulmonary infections due to brucellosis in childhood. Tuberk Toraks, 2020;68(1):43. https://doi.org/10.5578/tt.69015
  • 24. Karaman S, Bitkin E, Sonmez B, Basaranoglu M, Karaman K, Tuncer O. Clinical and laboratory findings of paediatric patients with brucellosis. Meandros Med Dent J, 2021;22:63-8. https://doi.org/10.4274/meandros.galenos.2021.94809
  • 25. Pourakbari B, Abdolsalehi M, Mahmoudi S, Banar M, Masoumpour F, Mamishi S. Epidemiologic, clinical, and laboratory characteristics of childhood brucellosis: A study in an Iranian children's referral hospital. Wien Med Wochenschr, 2019;169(9):232-9. https://doi.org/10.1007/s10354-019-0685-z
  • 26. Ma L, Ma J, Chen X, Dong L. A 10-year retrospective comparative analysis of the clinical features of brucellosis in children and adults. J Infect Dev Ctries, 2021;15(08):1147-54. https://doi.org/10.3855/jidc.13962
  • 27. Hassouneh L, Quadri S, Pichilingue-Reto P, Chaisavaneeyakorn S, Cutrell JB, Wetzel DM, et al. An outbreak of brucellosis: an adult and pediatric case series. Open Forum Infec Dis, 2019;6(10):ofz384. https://doi.org/10.1093/ofid/ofz384
  • 28. Serpa JA, Knights S, Farmakiotis D, Campbell J. Brucellosis in adults and children: a 10-year case series at two large academic hospitals in Houston, Texas. South Med J, 2018;111(6):324-7. https://doi.org/10.14423/SMJ.0000000000000810
  • 29. Justman N, Fruchtman Y, Greenberg D, Ben-Shimol S. Hematologic manifestations of brucellosis in children. Pediatr Infect Dis J, 2018;37(6):586-91. https://doi.org/10.1097/INF.0000000000001900
There are 29 citations in total.

Details

Primary Language English
Subjects Paediatrics
Journal Section Original Research
Authors

Taylan Çelik 0000-0002-7568-035X

Emre Kaan 0000-0002-4910-421X

Publication Date July 31, 2022
Submission Date December 11, 2021
Acceptance Date July 26, 2022
Published in Issue Year 2022Volume: 7 Issue: 3

Cite

APA Çelik, T., & Kaan, E. (2022). Brucellosis in childhood: retrospective evaluation of 37 cases and review of the literature. Family Practice and Palliative Care, 7(3), 84-91. https://doi.org/10.22391/fppc.1035377
AMA Çelik T, Kaan E. Brucellosis in childhood: retrospective evaluation of 37 cases and review of the literature. Fam Pract Palliat Care. July 2022;7(3):84-91. doi:10.22391/fppc.1035377
Chicago Çelik, Taylan, and Emre Kaan. “Brucellosis in Childhood: Retrospective Evaluation of 37 Cases and Review of the Literature”. Family Practice and Palliative Care 7, no. 3 (July 2022): 84-91. https://doi.org/10.22391/fppc.1035377.
EndNote Çelik T, Kaan E (July 1, 2022) Brucellosis in childhood: retrospective evaluation of 37 cases and review of the literature. Family Practice and Palliative Care 7 3 84–91.
IEEE T. Çelik and E. Kaan, “Brucellosis in childhood: retrospective evaluation of 37 cases and review of the literature”, Fam Pract Palliat Care, vol. 7, no. 3, pp. 84–91, 2022, doi: 10.22391/fppc.1035377.
ISNAD Çelik, Taylan - Kaan, Emre. “Brucellosis in Childhood: Retrospective Evaluation of 37 Cases and Review of the Literature”. Family Practice and Palliative Care 7/3 (July 2022), 84-91. https://doi.org/10.22391/fppc.1035377.
JAMA Çelik T, Kaan E. Brucellosis in childhood: retrospective evaluation of 37 cases and review of the literature. Fam Pract Palliat Care. 2022;7:84–91.
MLA Çelik, Taylan and Emre Kaan. “Brucellosis in Childhood: Retrospective Evaluation of 37 Cases and Review of the Literature”. Family Practice and Palliative Care, vol. 7, no. 3, 2022, pp. 84-91, doi:10.22391/fppc.1035377.
Vancouver Çelik T, Kaan E. Brucellosis in childhood: retrospective evaluation of 37 cases and review of the literature. Fam Pract Palliat Care. 2022;7(3):84-91.
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