Brucellosis: A Retrospective Evaluation of 170 Cases

Abstract

Brucellosis is an important disease with devastating outcomes in developing countries and may cause complications in many organ systems. The clinical and laboratory characteristics of 170 cases of brucellosis followed at the Afyon Kocatepe University Faculty of Medicine Infectious Diseases Clinic and Afyonkarahisar State Hospital of Medicine Infectious Diseases Clinic in Turkey, were retrospectively evaluated. In our study, total of 170 patients (female, n=74; 43.5%, and male, n=96; 56.5%) with a mean age of 44.12 ± 15.52 years were included. The patients were living in rural areas (n=134; 78.8%) or in the city center (n=36; 21.2%), while 112 (65.9%) patients were raising livestock and 84 patients (49.4%) were consumers of unpasteurized raw milk and dairy products. The most frequent complaints detected in patients with brucellosis include joint pain, fever, weakness, back pain and gastrointestinal symptoms. Fever, arthritis and scrotal swelling were observed more frequently than the others. The standard tube agglutination titer was > 1/160 in 150 (88.2%) patients. Blood cultures have positive results in 68 (59.6%) patients. Complications were detected in 45 patients (26.4%). Osteoarticular system involvement was the most common complication in 33 (19.4%) patients. Other complications were epididymo-orchitis in 9 (5.3%) and depression in 3 (1.8%) patients (Table 2). Sacroileitis was the most frequent osteoarticular involvement which was detected in 13 (7.6%) patients. Other osteoarticular involvements were peripheral monoarthritis in 11 (6.5%), and spondylodiscitis in 9 (5.3%) patients. Increased C-reactive protein (CRP) and high serum transaminase levels were significantly higher in the complication groups. The most frequent drug treatment was rifampicin and doxycyline among different treatment regimens. Brucellosis should be considered in the differential diagnosis of patients who present with fever and osteoarticular symptoms. Laboratory results can help the clinician to identify the complications of this disease, especially osteoarticular complications.