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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
A multicenter retrospective study of childhood brucellosis in Chicago, Illinois from 1986 to 2008
Latania K Logan1, Norman M Jacobs, James B McAuley
1Rush University Medical Center, 1653 West Congress Parkway, Suite 736 Murdock, Chicago, IL 60612, USA. latania_logan@rush.edu
Insights
Brucellosis in children is often linked to travel and unpasteurized milk. Early treatment with multiple drugs, including rifampin, may reduce Brucella relapse risk.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Brucellosis is a zoonotic disease caused by Brucella species.
- It can present with diverse clinical manifestations in children.
- Understanding pediatric brucellosis is crucial for timely diagnosis and management.
Purpose of the Study:
- To identify risk factors for acquiring Brucella in children.
- To describe the clinical presentation, treatment, and outcomes of pediatric brucellosis.
- To evaluate factors influencing disease relapse.
Main Methods:
- A retrospective multicenter chart review was conducted.
- Data were collected from children diagnosed with brucellosis between 1986 and 2008.
- Reviewed charts for risk factors, clinical signs, and treatment outcomes.
Main Results:
- Twenty-one pediatric brucellosis cases were analyzed.
- Key risk factors included travel to endemic areas (86%) and unpasteurized milk consumption (76%).
- Common symptoms were fever (95%), bacteremia (86%), and elevated liver enzymes (80%). Relapse rates were lower with multi-drug therapy (1/15) versus single-drug therapy (3/6).
Conclusions:
- Brucellosis should be considered in children with relevant exposure history and symptoms.
- Blood cultures are essential for diagnosis.
- Initiating treatment with two or more drugs, especially regimens including rifampin, may prevent Brucella relapse in children.
Objectives:
To determine risk factors in children for the acquisition of Brucella, clinical presentation, treatment, and disease outcomes.
Methods:
A retrospective multicenter chart review was undertaken of children identified with brucellosis from 1986 to 2008 at three tertiary care centers in Chicago, Illinois, USA. The charts were reviewed for data regarding risk factors for acquisition, clinical presentation, and outcomes.
Results:
Twenty-one charts were available for review. The median age was 6.5 years (range 2-14 years); 62% were female. Ethnic background was 67% Hispanic and 24% Arabic. Risk factors included travel to an endemic area (86%), particularly Mexico, and consumption of unpasteurized milk products (76%). Common findings included fever (95%), bacteremia (86%), elevated liver transaminases (80%), constitutional symptoms (76%), splenomegaly (60%), and hepatomegaly (55%). Relapse occurred in three of six subjects started on single drug treatment, but in only one of 15 subjects who started on two or more drugs (p=0.053). No relapses occurred in children whose initial therapy included rifampin or those administered three-drug regimens.
Conclusions:
Brucella is an infrequent pathogen but should be considered in children with compatible epidemiologic and clinical characteristics. Blood cultures should be obtained, and initial therapy with two or more drugs may decrease the risk of relapse.
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