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Published on: May 23, 2021
Presentation, complications, and treatment outcome of brucellosis in Turkish children
Gonul Tanir1, Sehra B Tufekci, Nilden Tuygun
1Department of Pediatrics, Dr Sami Ulus Children's Health and Diseases Training and Research Center, Ankara, Turkey. gonultanir58@yahoo.com
Insights
Childhood brucellosis in Turkey is often caused by unpasteurized milk. Effective treatments with co-trimoxazole or doxycycline plus rifampicin lead to rapid improvement and low relapse rates.
Area of Science:
- Infectious Diseases
- Pediatrics
- Public Health
Background:
- Brucellosis is a significant public health concern in Turkey, with children comprising 20-25% of cases.
- Endemic Brucella melitensis areas necessitate focused research on pediatric brucellosis.
Purpose of the Study:
- To retrospectively evaluate clinical characteristics and treatment outcomes of childhood brucellosis in Turkey.
- To identify common transmission routes, clinical presentations, and complications in pediatric brucellosis patients.
Main Methods:
- Retrospective analysis of hospital records for 90 children diagnosed with brucellosis between 1997 and 2006.
- Evaluation of patient demographics, transmission sources, clinical findings, diagnostic tests, treatment regimens, and outcomes.
Main Results:
- The majority of pediatric brucellosis cases (70%) were male, with a mean age of 9.02 years.
- Consumption of unpasteurized milk/dairy products was the primary transmission route (71.1%).
- Joint involvement (arthralgia, arthritis) was common, with rapid response to treatment; however, complications like neurobrucellosis occurred in some patients.
Conclusions:
- Combined antibiotic therapy (co-trimoxazole or doxycycline with rifampicin) is effective for childhood brucellosis, achieving low relapse rates.
- Triple-drug regimens successfully treated complications and relapses, with minimal long-term sequelae.
Background:
Brucellosis constitutes a public health problem in Turkey. In endemic Brucella melitensis areas such as Turkey, children represent 20-25% of cases.
Methods:
Hospital records of 90 children with brucellosis admitted during a 9 year period, 1997-2006, were evaluated retrospectively.
Results:
Of 90 patients, 27 (30%) were female and 63 (70%) were male (P < 0.05). Patients were aged between 1 and 16 years of age. The mean age was 9.02 +/- 3.59 years. Fifty-two patients (57.8%) were from rural areas of Turkey. The mode of transmission was consumption of unpasteurized milk and milk products in 64 patients (71.1%). Parents of 41 patients (45.6%) worked in animal breeding. A positive family history for brucellosis was noted in 14 patients (15.6%). The most frequently involved joint with arthralgia was the knee joint. Arthritis was found in six patients (6.7%), and five of the six had monoarthritis. Serum agglutination test was >or=1/160 in 82 patients (91.1%). The joint symptoms rapidly responded to the treatment and the majority of the patients had significant improvement. The duration of treatment was 6 weeks in 81 patients (90%). Six patients experienced relapse. Four patients presented with complications that included neurobrucellosis, discitis and sclerosis of the hip joint.
Conclusions:
Treatment of childhood brucellosis with co-trimoxazole + rifampicin or doxycycline + rifampicin, according to patient age, is effective and has low relapse rates. Complications and relapse were successfully treated with triple-drug regimens with a low sequelae rate.
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