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Acute brucellosis in children commonly presents as arthritis, particularly affecting the knee and hip. Prompt antibiotic treatment ensures recovery, though reinfections can occur.
Area of Science:
- Pediatrics
- Infectious Diseases
- Rheumatology
Background:
- Brucellosis is an endemic zoonotic infection.
- Acute arthritis is a frequent manifestation in pediatric brucellosis.
- Distinguishing brucellar arthritis from other septic arthritis forms is crucial.
Purpose of the Study:
- To investigate the clinical presentation and outcomes of acute brucellosis in children.
- To highlight acute arthritis as a predominant symptom.
- To evaluate treatment efficacy and identify potential complications.
Main Methods:
- Retrospective analysis of 50 children diagnosed with acute brucellosis.
- Clinical evaluation, serological testing (Brucella agglutination titer ≥ 1:320), and blood cultures.
- Assessment of treatment regimens including tetracyclines, trimethoprim-sulphamethoxazole, and streptomycin.
Main Results:
- Acute arthritis was a common and often predominant symptom in pediatric brucellosis.
- Knee and hip joints were most frequently affected.
- Antibiotic therapy led to prompt recovery in all patients; no mortality was observed.
- Brucella melitensis was identified in 35 patients via blood culture.
- Seven patients experienced reinfections; two developed osteomyelitis but recovered without sequelae.
Conclusions:
- Acute arthritis is a significant clinical manifestation of brucellosis in endemic pediatric populations.
- Standard antibiotic treatments are effective, leading to good prognoses.
- Monitoring for reinfections and complications like osteomyelitis is recommended.
Abstract:
A study in 50 children suffering from acute brucellosis demonstrated that acute arthritis is a common and often predominant manifestation of the disease. The patients lived in an area where brucellosis is endemic: their ages ranged from six months to 12 years. All patients had a brucella agglutination titer of greater than or equal to 1:320 on admission. The knee and hip joints were most commonly affected with symptoms and findings from only one joint predominating. Associated findings of only moderately elevated ESR and normal leucocyte counts with relative lymphocytosis in the vast majority of the cases made it fairly easy to distinguish acute brucella arthritis from septic arthritis of other origin. A positive blood culture for Brucella melitensis was obtained in 35 of the patients. Treatment with tetracyclines, trimethoprim-sulphamethoxazole, with or without combination with streptomycin, resulted in a prompt recovery in all patients. No mortality was seen. Seven patients were readmitted with reinfections during a mean follow-up period of 13 months. Two patients with a history of prolonged fever, malaise and arthralgia were found to have osteomyelitis of the adjacent bone tissue. They also recovered without sequelae.