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Published on: May 23, 2021
Childhood brucellosis: Review of 317 cases
Mile Bosilkovski1, Ljiljana Krteva2, Sonja Caparoska2
1Medical Faculty, 'Ss Cyril and Methodius' University, Skopje, Macedonia.
Insights
Childhood brucellosis is a significant concern in endemic areas, often presenting with fever and joint pain. Prompt recognition of symptoms like fever, joint pain, and organ involvement is crucial for effective pediatric brucellosis management.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology of Zoonotic Diseases
- Public Health in Endemic Regions
Background:
- Brucellosis is a zoonotic disease with significant global health implications.
- Childhood brucellosis constitutes a notable proportion of human brucellosis cases in endemic areas.
- Understanding the specific characteristics of brucellosis in children is essential for accurate diagnosis and treatment.
Purpose of the Study:
- To delineate the epidemiological, clinical, and laboratory features of pediatric brucellosis.
- To review treatment strategies and patient outcomes for childhood brucellosis.
- To enhance awareness among healthcare providers regarding pediatric brucellosis.
Main Methods:
- Retrospective analysis of data from 317 pediatric patients diagnosed with brucellosis.
- Data collected from the University Clinic for Infectious Diseases and Febrile Conditions in Skopje between 1989 and 2011.
- Evaluation of medical records and follow-up protocols to assess patient characteristics and outcomes.
Main Results:
- Pediatric brucellosis accounted for 18.7% of all brucellosis cases (317/1691).
- The median age of affected children was 9 years, with a male predominance (63.4%).
- Common symptoms included fever (78.2%), joint pain (71.9%), and hepatomegaly (68.1%), with organ involvement in 65.0% of cases. Relapses occurred in 6.6% of patients.
Conclusions:
- Childhood brucellosis is a significant public health issue in endemic regions, characterized by diverse clinical presentations and potential for serious complications.
- The disease frequently affects multiple organ systems and can lead to relapses, underscoring its severity in children.
- Pediatricians should maintain a high index of suspicion for brucellosis in children presenting with fever, joint pain, sweating, and systemic involvement from endemic areas.
Objective:
To describe the main epidemiological, clinical, and laboratory features, treatment options and outcome in children with brucellosis.
Methods:
Retrospectively evaluated data were obtained from 317 pediatric patients with brucellosis that were treated at the University Clinic for Infectious Diseases and Febrile Conditions in Skopje, during the period from 1989 to 2011. The medical records and follow-up protocols were used for evaluation.
Results:
Childhood brucellosis composed 317 (18.7%) of 1691 patients with brucellosis. The patients were median 9 years old, ranging from 7 months to 14 years, and 201 (63.4%) were males. Family history was present in 197 (62.1%), and direct contact with animals occurred in 140 (44.2%) of the children. The dominant manifestations were fever in 248 (78.2%), joint pain in 228 (71.9%) and hepatomegaly in 216 (68.1%). Organ affection was present in 206 (65.0%) of the patients. One hundred and six (33.4%) of the patients were treated with combination composed of two, and 211 (66.6%) with three antimicrobial agents. Relapses were registered in 21 (6.6%), and therapeutic failures in 3 (0.9%) of the children.
Conclusions:
In endemic regions childhood brucellosis represents a significant part of human cases. Wide spectrum of clinical manifestations, frequent affection of various organ systems and possibility of relapses show that brucellosis could be a serious disease in this age group. The presence of fever, joint pain, sweating, and affection of various systems in children from endemic regions should alert pediatricians for the possibility of brucellosis.
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