Clinical, Diagnostic and Therapeutic Approaches to Complications of Brucellosis: An Experience of 12 Years

Abstract

Objective: To describe the clinical presentations, laboratory findings, prevalence and pattern of complications and the response to treatment of brucellosis in a 12-year period in a Turkish research hospital. Materials and Methods: Between 1996 and 2008, 231 patients were diagnosed with brucellosis and treated in our clinic. Medical records of 189 of the 231 patients with at least one demonstrable complication of the disease were reviewed for anamnesis, diagnosis, complications, treatment and clinical outcomes. Results: The decreasing order of the complications was: hematological, 104 (55%); osteoarticular, 70 (37%); hepatobiliary, 59 (31%), and gastrointestinal, 23 (12%). The most common laboratory findings were anemia, lymphomonocytosis, elevated sedimentation rate and C-reactive protein, and elevated aminotransaminases. Conclusion: The hematological, osteoarticular and hepatobiliary manifestations were predominant. Bursitis, synovitis, glomerulonephritis, cutaneous lesion and deep vein thrombosis were the rare complications observed in our study. In clinical practice, brucellosis should be considered in the differential diagnosis in the presence of infrequent complications.

Human brucellosis in Turkey: different clinical presentations

“…[36] and Gur et al [17] reported higher ratios of osteoarticular involvement (68.1% and 69%, respectively) than we did in our study. Similar to our findings, Turan et al [37] and others reported 43.7% and 46.5% osteoarticular involvement, respectively [15,23]. In these studies, spondylodiscitis was the most frequent osteoarticular complication, similar to previous studies [15,22,23].…”

“…Similar to our findings, Turan et al [37] and others reported 43.7% and 46.5% osteoarticular involvement, respectively [15,23]. In these studies, spondylodiscitis was the most frequent osteoarticular complication, similar to previous studies [15,22,23]. In some studies conducted in Turkey, however, sacroileitis or peripheric arthritis was found to be the most common form of osteoarticular involvement [17,37].…”

“…These complications include osteoarticular, gastrointestinal, hematological, genitourinary, cardiovascular, respiratory, and central nervous system involvement [28]. Although osteoarticular complications are usually the most frequently occurring complications of brucellosis, the most frequent complications in our study were hematological complications (58.1%), similar to the study of Mermut et al [23]. This was followed by osteoarticular (48.3%), hepatobiliary (26.7%), gastrointestinal (10%), and genitourinary (4.8%) complications.…”

“…Genitourinary complications have been reported in 2%-40% of patients with brucellosis, and the most frequent one is epididymoorchitis [1,2,17,23]. In our study, orchitis developed in only 16 (4.3%) patients with brucellosis.…”

“…Anemia, leukopenia, and lymphomonocytosis are frequently seen hematological disturbances, whereas leukocytosis, neutropenia, thrombocytopenia, hemolytic anemia, and pancytopenia are rarely seen [21]. Brucellosis should be considered a possible cause of febrile neutropenia, especially in endemic areas.In various studies, different ratios ofanemia (41%-74%) [23,24], leukopenia (30%-68%) [19,30], and thrombocytopenia (28%-40%) [23] have been reported. In accordance with other studies, anemia was the most frequent hematological change found in our study.…”