A Systematic Review and Meta-Analysis of Epidemiology and Clinical Manifestations of Human Brucellosis in China

Abstract

Background. Brucellosis has a wide spectrum of clinical manifestations and it may last several days or even several years; however, it is often misdiagnosed and therefore may cause inadequate therapy and prolonged illness. Previous studies about meta-analysis of manifestations of brucellosis reported in English lacked the data published in Chinese, which did not provide details about the contact history, laboratory tests, and misdiagnosis. We undertake a meta-analysis of clinical manifestations of human brucellosis in China to identify those gaps in the literature. We have searched published articles in electronic databases up to December 2016 identified as relating to clinical features of human brucellosis in China. 68 studies were included in the analysis. The main clinical manifestations were fever, fatigue, arthralgia, and muscle pain (87%, 63%, 62%, and 56%, resp.). There are significant differences between adults and children. Rash, respiratory and cardiac complications, and orchitis/epididymitis were more prevalent in children patients. The common complications of brucellosis were hepatitis, followed by osteoarthritis, respiratory diseases, cardiovascular diseases, central nervous system dysfunction, hemophagocytic syndrome, and orchitis/epididymitis in male. In the nonpastoral areas, brucellosis has a high ratio of misdiagnosis. Our analysis provides further evidence for the accurate diagnosis, particularly in assessing severe, debilitating sequelae of this infection.

Search trends and prediction of human brucellosis using Baidu index data from 2011 to 2018 in China

“…After the initial infection, brucellosis has a wide range of clinical manifestations in the acute stage: patients can develop fever, sweating, and arthritis. Without appropriate treatment, the disease will progress to the chronic stage, which is far more severe than the acute stage 2 , such as endocarditis, neurological diseases 3,4 . Brucellosis is transferred from livestock to humans through nonsterile or contaminated products or contact with sick animals, and there have been no clear cases of brucellosis transfer from person to person 5 .…”

“…Moreover, brucellosis has several other epidemiological characteristics. For example, according to a previous study and reports, in terms of age and gender, young and middle-aged males in the labour force, especially those who work with livestock, are the main population being infected 3 .…”

A man with recurrent fever, arthritis, and rashes-brucellosis? A case report

“…Although hematological involvement is frequent in brucellosis, most of such cases are mild, and serious clinical disease is rare. The most commonly reported abnormal laboratory tests are aleucocytosis, anemia, thrombocytopenia, pancytopenia and leukocytosis [3]. The patient had severe anemia and his Hb was 36 g/L, which was difficult to explain with brucellosis.…”

Brucellosis Spinal Epidural Abscess: A Case Series of Fourteen Patients

“…Brucella species can be cultured in blood or tissue samples to authoritatively diagnose brucellosis, but the positive rate is low. Most reports in the literature are diagnosed by brucella serology [12,25,26]. Magnetic resonance imaging (MRI) is the gold standard for diagnosis of SEA [15,27,28].…”