Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients

Aygen, Bilgehan; Doğanay, Mehmet; Sümerkan, Bülent; Yıldız, Orhan; Kayabaş, Üner

doi:10.1016/s0399-077x(02)00403-1

Cited by 118 publications

(141 citation statements)

References 37 publications

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“…Unfavorable outcomes usually have to be ascribed to the inability to eradicate the bacteria from their intracellular niche. In adequately treated patients, relapses occur in 0 to 16% of the cases (14,31,33,38,41,45,(80)(81)(82). The frequency of relapses found in our patients is similar to those mentioned in other reports (27,35,(83)(84)(85).…”

Section: Discussionsupporting

confidence: 90%

“…In addition, the number of patients suffering from focal involvement ranges from 6% to 92% (20,21,42,54) and is usually about 30% (14,15,38,41,55). In our study, twothirds of the enrolled patients had focal manifestations and osteoarticular forms predominated, similar to other reports (1,15,20,28,44).…”

Section: Discussionmentioning

confidence: 99%

“…In the recent decades with the use of appropriate antimicrobial treatment, the mortality rate has been lower than 1% (4,14,29,41,68). However, there are exceptions, in non-endemic countries as a result of the decreasing knowledge about the disease and in endemic regions of the developing world due to lack of medical care.…”

Section: Discussionmentioning

confidence: 99%

“…Of course, mortality rates might be biased by the selection of patients with specific clinical manifestations; for example, the rate was 2.1% in a series of patients with vertebral osteomyelitis in Spain (71). Brucella endocarditis is the main cause of death attributable to this disease (72)(73)(74), but many other causes have been described, eg, endotoxic shock with disseminated intravascular coagulation (75), rupture of a mycotic aneurysm (76), aortitis with mesenteric thrombosis (41), myocarditis (77), dissemination with multifocal liver and lung nodules (78), thrombocytopenia (79), and neurobrucellosis (14,29,41). We had only one mortality case as a direct consequence of brucellosis.…”

Section: Discussionmentioning

confidence: 99%

“…Hepatic involvement was defined as more than a 2-fold increase in alanine aminotransferase levels above the reference values (13). Neurobrucellosis was defined as presence of neurological dysfunction, not otherwise explainable, in combination with pathologic laboratory findings in the cerebrospinal fluid, ie, >10 cells/mL or protein concentrations >0.45 g/L and detection of anti-Brucella antibodies (14,15). Endocarditis was confirmed by auscultation of a cardiac murmur and detection of valvular vegetations using trans-thoracic echocardiography (15).…”

Section: Methodsmentioning

confidence: 99%

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Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region

Bosilkovski¹,

Krteva²,

Dimzova³

et al. 2010

Croat Med J

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Aim To present our 10-year clinical experience with brucellosis patients at the University Clinic for Infectious Diseases and Febrile Conditions in Skopje, Republic of Macedonia.Methods A total of 550 patients with brucellosis treated between 1998 and 2007 were retrospectively assessed for their demographic, epidemiological, and clinical characteristics and outcomes.Results Of the 550 patients, 395 (72%) were male. The median age was 34.5 years (range, 1-82). Direct contact with infected animals was recorded in 333 (61%) patients and positive family history in 310 (56%). The most frequently seen symptoms were arthralgia (438, 80%), fever (419, 76%), and sweating (394, 72%). The most common signs were fever and hepatomegaly, which were verified in 357 (65%) and 273 (50%) patients, respectively. Focal brucellosis was found in 362 patients (66%) and osteoarticular in 299 (54%). Therapeutic failures were registered in 37 (6.7%) patients. Of the 453 (82%) patients who completed a follow-up period of at least 6 months, relapses occurred in 60 (13%). ConclusionDue to non-specific clinical manifestation and laboratory parameters, brucellosis should be considered one of the differential diagnoses of any patient suffering from obscure involvement of various organs in a brucellosis-endemic region. High percentage of relapses and therapeutic failures in spite of the use of currently recommended therapeutic regimens indicates the seriousness of this zoonosis and the need to control it.

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