Brucellosis in Childhood: A Study of 43 Cases

Aim: Brucellosis is a frequently encountered zoonosis in our country. In this study, we aimed to evaluate the patients with regard to the clinical and laboratory findings as well as the treatment responses. Material and Method: The medical records of 43 patients with brucellosis followed up from January 1995 to December 2006 were retrospectively reviewed. Brucellosis was diagnosed by an increased agglutination titer and/or isolation of the organism by culture in the presence of clinical findings. Results: The mean age was 6.9 years and the ratio of girls to boys was 20/23. 67% of the patients stated that they consumed unpasteurized fresh cheese, 2 patients had animal contact. Other cases of brucellosis were determined in the families of 23 patients. The most frequent complaint was fever (95%); followed by weakness (37%), abdominal pain (28%), arthralgia (21%), weight loss (16%) and headache (14%). Fever was determined in 26 patients, splenomegali in 19, hepatomegali in15, and arthritis in only 5 cases. Brucella agglutination titer was 1/160 in 6 cases, 1/320 in 27 cases, 1/640 in 8 cases and over 1/640 in one patient. Brucella was isolated in blood culture of 3 patients and cerebrospinal fluid in one patient. 16 patients over 8 years of age were treated with doxycycline (100 mg, bid, for 6 weeks) and gentamicin (5 mg/kg, IM, for 2 weeks). 23 of the 27 patients below 8 years were treated with TMP/SMX (5mg/kg/day TMP bid, for 6 weeks) and gentamicin (5 mg/kg IM, for 2 weeks), while the other 4 received rifampicin (5mg/kg/day bid, for 6 weeks) and gentamicin (5 mg/day, IM, for 2 weeks). No relapses occurred. Conclusion: Brucellosis can involve any organ of the body causing a wide spectrum of disease. It should be kept in mind in the differantial diagnosis of fever, arthritis, hepatosplenomegaly and anemia. It should be considered that there may also be atypical clinical forms.