Related Experiment Videos
Brucellosis in childhood in the Western Cape
M K Hendricks1, E M Perez, P J Burger
1Department of Paediatrics, Tygerberg Hospital, University of Stellenbosch, Tygerberg, W. Cape.
Insights
Human brucellosis in children is often missed but treatable. Diagnosis relies on serology, with the Coombs test confirming cases affected by the prozone phenomenon. Treatment with antibiotics for at least six weeks led to no relapses.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Human brucellosis is a multisystem disease with low incidence in childhood, often mimicking other conditions and leading to diagnostic challenges.
- Brucellosis diagnosis in pediatric patients can be delayed due to its non-specific symptoms and rarity.
- Consumption of unpasteurized milk is a significant risk factor for acquiring brucellosis.
Purpose of the Study:
- To describe the clinical presentation, diagnosis, and treatment of brucellosis in children.
- To highlight the importance of considering brucellosis in pediatric patients with relevant symptoms.
- To evaluate treatment outcomes and identify potential diagnostic difficulties.
Main Methods:
- Retrospective case series of 9 pediatric patients diagnosed with brucellosis over a 7-month period.
- Clinical data including presenting symptoms, physical signs, and diagnostic test results were reviewed.
- Treatment regimens were based on patient age, with follow-up to assess for relapses.
Main Results:
- Nine pediatric cases of brucellosis were identified, with 6 linked to unpasteurized milk consumption.
- Common presenting symptoms included fever, fatigue, headache, myalgia, and hematuria.
- Serological testing for Brucella abortus with a titre > 1:160 was diagnostic, with the Coombs test crucial for cases exhibiting the prozone phenomenon.
Conclusions:
- Brucellosis in children, though uncommon, requires a high index of suspicion due to its varied presentation.
- Accurate diagnosis can be achieved through serological methods, including the Coombs test to overcome the prozone phenomenon.
- Standard antibiotic treatment regimens for at least six weeks appear effective, with no relapses observed in this cohort.
Abstract:
Human brucellosis, a multisystem disease which may mimic other conditions, has a low incidence in childhood and the diagnosis may easily be missed. Over a 7-month period 9 children with brucellosis presented to the Department of Paediatrics and Child Health, Tygerberg Hospital. Six of the children had consumed unpasteurized milk. The main presenting symptoms were fever, fatigue, headache, myalgia and haematuria. Clinical signs included lymphadenopathy (3), nasopharyngitis (2), features of lower respiratory tract infection (2), splenomegaly (2) and pyrexia (1). The diagnosis was made on the basis of a positive serological titre (> 1:160) for Brucella abortus. The prozone phenomenon was encountered in 6 cases; however, the Coombs test confirmed the diagnosis in these cases. Children under 7 years were treated with co-trimoxazole and rifampicin and those over 7 years with tetracycline and rifampicin, for at least 6 weeks. No relapses were detected on follow-up.