Pediatric brucellosis in the central mediterranean region of Türkiye: Insights from a single-center experience

Abstract

Objective: We aimed to contribute to the literature by presenting the epidemiologic, clinical, and laboratory characteristics of pediatric patients with brucellosis followed up by our clinic. Method: The medical records of patients aged 0-18 years who were followed up with a diagnosis of brucellosis in Gazi University Pediatric Infectious Diseases Clinic between 2010-2020 were retrospectively analyzed. The effect of demographic, clinical, and laboratory markers on diagnosis was investigated. Results: The mean age was 162.0 ± 55.5 months. Of the 47 patients included in our study, 68% lived in rural areas. While 82.5% had a background of consuming raw milk and dairy products, 55% had experience in animal husbandry. Twenty-two patients had a family history of brucellosis. The most common symptoms were joint pain in 85%, malaise in 78%, and muscle pain in 42%. The most common associated findings were fever in 59%, joint stiffness in 23%, and splenomegaly in 17%. The decrease in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values and the increases in leukocytes, hemoglobin, and platelets before and after treatment were statistically significant (p<0.001). Anemia was the most common in the patients, followed by neutropenia, thrombocytopenia, thrombocytosis, leukocytosis, and pancytopenia, respectively. Blood culture positivity was 12%. Of 47 patients with positive tube agglutination titer, Rose Bengal was positive in 80% and negative in 19%. Conclusion: Brucellosis remains an important public health problem in Türkiye. Patients should be questioned in detail in the presence of fever, arthralgia, hepatosplenomegaly, and pancytopenia which presents with different clinical findings. Rose Bengal negativity, which is used as a screening test, should not mislead us in making a diagnosis in the presence of clinical suspicion. Tube agglutination tests should definitely be performed in patients with suspected brucellosis. In addition, changes in non-specific blood parameters such as CRP, ESR, leukocytes, hemoglobin, and platelets may be indicative for clinicians.