Öz
Amaç: Brusellozun kesin tanısı bakterinin izolasyonu ile konsa da çoğunlukla
klinik ve laboratuvar bulgulara dayanır. Bu çalışmanın amacı bruselloz'un
tanısında gereken parametreleri ve tahmin değerlerini araştırmaktır.
Gereç ve Yöntem: Kültürde izole ederek tanı konan 50 bruselloz hastasının klinik ve
laboratuvar bulguları ile klinikte ateş nedeni ile yatırılmış 50 hastanın
bulguları retrospektif olarak taranarak karşılaştırıldı. Bu veriler lojistik
regresyon analizi ile değerlendirildi. Sensitivite, spesifisite, pozitif ve
negatif prediktif değerler hesaplandı.
Sonuçlar: Brusellozun anlamlı klinik özellikleri; hepatomegali, splenomegali,
artrit, RF pozitifliği, lökopeni, trombositopeni, anemi ve artmış ALT
seviyeleri olarak saptandı. Bu özelliklerden ise splenomegali, artrit, RF
pozitifliği, trombositopeni ve artmış ALT seviyelerinin Bruselloz'un
tanısında anlamlı tahmin değerlerine sahip olduğu tespit edildi.
Yorum: Bruselloz'un tanısında serum aglütinasyon testlerinin yeterli, yüksek
düzeyde spesifisite ve sensitivite değerleri bulunmamakta, kültür sonuçlarının
beklenmesi de tedaviyi geciktirebilmektedir. Bu nedenle endemik bölgelerde
bruselloz tanısı için bu sonuçların tahmini tanısal değerleri göz önünde
bulundurulmalıdır.
Kaynakça
- Dear Editor-in-Chief: Please find enclosed our manuscript entitled “Predictive value of clinical and laboratory findings in the diagnosis of Brucellosis,” which we request you to consider for publication as an Original Article. Brucellosis is a zoonotic infection caused by the genus Brucella, causing a plethora of debilitating diseases. Given the protean and often non-specific nature of symptoms, clinical diagnosis of brucellosis is difficult; confirmation of infection largely depends on obtaining samples promptly with consequent laboratory confirmation and initiation of immediate antibiotic treatment. In our study, we aimed to elucidate the minimum-required laboratory and clinical parameters that can be used in the prompt diagnosis of brucellosis. We conducted a retrospective study to compare the clinical and laboratory findings from 50 patients who were microbiologically confirmed as having Brucella spp. infection and 50 patients with fever. Using multivariate logistic regression, we were able to confirm that splenomegaly [odds ratio (OR) 8.13, 95% confidence interval (CI)], arthritis (OR 16.59, 95% CI), rheumatoid factor positivity (OR 4.86, 95% CI), thrombocytopenia (OR 7.87, 95% CI), and elevated ALT levels (OR 5.3, 95% CI) were independent predictors in brucellosis diagnosis. Although our study was small, these findings are of interest, considering the significant statistical differences. The predictive values of these clinical and laboratory markers are worth considering in countries where brucellosis remains endemic. This manuscript has not been published elsewhere and is not under consideration by another journal. There are no conflicts of interest to declare. I believe that the findings of this study are relevant to the scope of your journal and will be of interest to its readership. The manuscript has been carefully reviewed by an experienced editor whose first language is English and who specializes in editing papers written by scientists whose native language is not English. I look forward to hearing from you at your earliest convenience. Sincerely, Ozgur Dagli MD,
Öz
Objectives: Although
the definitive diagnosis of brucellosis requires isolation of the Brucella species, diagnosis is usually
made based on both clinical and laboratory findings. The aim of this study was
to determine the minimum required parameters that could be valuable in the
diagnosis of brucellosis.
Material and Method: A
retrospective study was performed to compare the clinical and laboratory
findings in 50 patients who were
confirmed to have brucellosis by cultures with 50 patients with fever. Features
independently predictive of brucellosis were assessed by multivariate logistic
regression. Sensitivity, specificity and positive and negative predictive
values were estimated.
Results:
Significant clinical features of brucellosis were hepatomegaly, splenomegaly, arthritis,
RF positivity, leucopenia, thrombocytopenia, anemia, and elevated ALT
levels. Five of these features were found to be predictive for the diagnosis of
brucellosis; splenomegaly, arthritis, RF positivity, thrombocytopenia and
elevated ALT levels.
Conclusion: For
the diagnosis of brucellosis, serum aglutination test does not have high
specificity and sensitivity and waiting the results of cultures will delay the
proper treatment. Predictive
value of these results are worth taking into
consideration in endemic regions.
Anahtar Kelimeler
Kaynakça
- Dear Editor-in-Chief: Please find enclosed our manuscript entitled “Predictive value of clinical and laboratory findings in the diagnosis of Brucellosis,” which we request you to consider for publication as an Original Article. Brucellosis is a zoonotic infection caused by the genus Brucella, causing a plethora of debilitating diseases. Given the protean and often non-specific nature of symptoms, clinical diagnosis of brucellosis is difficult; confirmation of infection largely depends on obtaining samples promptly with consequent laboratory confirmation and initiation of immediate antibiotic treatment. In our study, we aimed to elucidate the minimum-required laboratory and clinical parameters that can be used in the prompt diagnosis of brucellosis. We conducted a retrospective study to compare the clinical and laboratory findings from 50 patients who were microbiologically confirmed as having Brucella spp. infection and 50 patients with fever. Using multivariate logistic regression, we were able to confirm that splenomegaly [odds ratio (OR) 8.13, 95% confidence interval (CI)], arthritis (OR 16.59, 95% CI), rheumatoid factor positivity (OR 4.86, 95% CI), thrombocytopenia (OR 7.87, 95% CI), and elevated ALT levels (OR 5.3, 95% CI) were independent predictors in brucellosis diagnosis. Although our study was small, these findings are of interest, considering the significant statistical differences. The predictive values of these clinical and laboratory markers are worth considering in countries where brucellosis remains endemic. This manuscript has not been published elsewhere and is not under consideration by another journal. There are no conflicts of interest to declare. I believe that the findings of this study are relevant to the scope of your journal and will be of interest to its readership. The manuscript has been carefully reviewed by an experienced editor whose first language is English and who specializes in editing papers written by scientists whose native language is not English. I look forward to hearing from you at your earliest convenience. Sincerely, Ozgur Dagli MD,
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 10 Sayı: 2 |
e-ISSN: 2548-0251
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