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Brucellosis in childhood

L Street, W W Grant, J D Alva

    Pediatrics
    |March 1, 1975
    PubMed
    Summary
    This summary is machine-generated.

    Brucellosis is an uncommon childhood illness. Pediatricians should consider brucellosis in children with unexplained fever or enlarged liver/spleen, especially after consuming unpasteurized dairy products.

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    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Microbiology

    Background:

    • Brucellosis is rare in children, with decreasing reports due to animal disease control.
    • Pediatricians may be unfamiliar with the diverse clinical presentations of childhood brucellosis.
    • A cluster of nine pediatric cases in El Paso, Texas, highlighted the disease's protean manifestations.

    Purpose of the Study:

    • To describe the clinical features, diagnosis, and treatment of a brucellosis outbreak in children.
    • To emphasize the importance of considering brucellosis in pediatric patients with obscure fever and hepatosplenomegaly.

    Main Methods:

    • Retrospective review of nine pediatric brucellosis cases.
    • Clinical data collection including symptoms, physical findings, laboratory results, and diagnostic methods.

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  • Microbiological investigation, including blood and bone marrow cultures.
  • Treatment efficacy assessment based on clinical response to antibiotics.
  • Main Results:

    • Cases presented with spiking fevers, lethargy, tender hepatosplenomegaly, epistaxis, arthralgia, myalgia, and weight loss.
    • Laboratory findings included leukopenia or leukemoid reaction and elevated liver enzymes.
    • Febrile agglutinins were crucial for diagnosis; Brucella was isolated from seven patients.
    • Unusual isolation of Brucella melitensis, linked to consumption of unpasteurized goat's milk cheese from Mexico.
    • All patients showed rapid improvement with a combination of oral tetracycline and intramuscular streptomycin.

    Conclusions:

    • Brucellosis presents with varied symptoms in children, including fever and hepatosplenomegaly.
    • Prompt diagnosis relies on clinical suspicion, serological tests (febrile agglutinins), and prolonged blood/bone marrow cultures.
    • Consumption of unpasteurized dairy products is a significant risk factor, necessitating pediatrician awareness in endemic or risk areas.