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Pediatric Brucellosis: A Challenging Diagnosis-Case Report
Areeba Shaikh1, Munira Sarfaraz1, Shaista Ehsan1
1Dr Ziauddin Hospital Clifton Karachi, Karāchi, Sindh, Pakistan.
Insights
This study highlights pediatric brucellosis in Pakistan, a widespread zoonotic disease. Early diagnosis and appropriate antimicrobial treatment, including doxycycline and rifampicin, are crucial for symptom improvement in children.
Area of Science:
- Infectious Diseases
- Pediatric Medicine
- Public Health
Background:
- Brucellosis is a significant zoonotic disease with limited literature in Pakistan, potentially causing diagnostic delays.
- This study addresses the gap by focusing on pediatric brucellosis, detailing its epidemiology, clinical presentation, and treatment outcomes.
- Understanding brucellosis in children is vital for public health initiatives in endemic regions.
Observation:
- An 11-year-old child presented with prolonged abdominal pain and fever.
- Abdominal ultrasound revealed hepato-splenomegaly and pleural effusion.
- Diagnostic workup, including antibody tests, confirmed brucellosis.
Findings:
- The child received a three-month course of doxycycline, rifampin, and trimethoprim-sulfamethoxazole.
- Treatment was continued with oral doxycycline and rifampicin for five weeks.
- Significant symptom improvement was observed by the end of the treatment regimen.
Implications:
- Brucellosis requires prompt diagnosis and multi-drug antimicrobial therapy, considering the intracellular nature of *Brucella*.
- Treatment protocols may need adjustment based on patient age and clinical complications.
- This case contributes valuable data to the understanding of pediatric brucellosis management.
Background:
Brucellosis is the second most widely spread zoonotic disease. There is less literature on this disease in Pakistan, leading to delayed diagnosis, or the patient remains undiagnosed. This study aims to contribute to Pediatric brucellosis literature, epidemiological, clinical features, laboratory findings, and treatment.
Case Presentation:
We present an 11-year-old child who was admitted to the hospital due to abdominal pain for one month and a fever for 15 days. On abdominal ultrasound, she had hepato-splenomegaly with minimal pleural effusion. A comprehensive diagnostic workup for infectious and immunologic disorders confirmed brucellosis with the antibody tests report. She received doxycycline, rifampin, and trimethoprim-sulfamethoxazole for three months. The treatment was continued with Syrup Doxycycline (50 mg/5 ml), and Syrup Rifampicin (2 g/100 ml) was prescribed for five weeks. Her symptoms were improved by the end of the treatment.
Conclusion:
Brucella is an intracellular pathogen affecting multi-systems of the human body; thus, the treatment is started with antimicrobials that have penetrative effects on a cell. The treatment can be adjusted based on the age group and the complication of the symptoms.
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