Presentation, complications, and treatment outcome of brucellosis in Turkish children

Pediatr Int. 2009 Feb;51(1):114-9. doi: 10.1111/j.1442-200X.2008.02661.x.

Abstract

Background: Brucellosis constitutes a public health problem in Turkey. In endemic Brucella melitensis areas such as Turkey, children represent 20-25% of cases.

Methods: Hospital records of 90 children with brucellosis admitted during a 9 year period, 1997-2006, were evaluated retrospectively.

Results: Of 90 patients, 27 (30%) were female and 63 (70%) were male (P < 0.05). Patients were aged between 1 and 16 years of age. The mean age was 9.02 +/- 3.59 years. Fifty-two patients (57.8%) were from rural areas of Turkey. The mode of transmission was consumption of unpasteurized milk and milk products in 64 patients (71.1%). Parents of 41 patients (45.6%) worked in animal breeding. A positive family history for brucellosis was noted in 14 patients (15.6%). The most frequently involved joint with arthralgia was the knee joint. Arthritis was found in six patients (6.7%), and five of the six had monoarthritis. Serum agglutination test was >or=1/160 in 82 patients (91.1%). The joint symptoms rapidly responded to the treatment and the majority of the patients had significant improvement. The duration of treatment was 6 weeks in 81 patients (90%). Six patients experienced relapse. Four patients presented with complications that included neurobrucellosis, discitis and sclerosis of the hip joint.

Conclusions: Treatment of childhood brucellosis with co-trimoxazole + rifampicin or doxycycline + rifampicin, according to patient age, is effective and has low relapse rates. Complications and relapse were successfully treated with triple-drug regimens with a low sequelae rate.

MeSH terms

  • Brucellosis* / complications
  • Brucellosis* / diagnosis
  • Brucellosis* / drug therapy
  • Brucellosis* / epidemiology
  • Child
  • Female
  • Humans
  • Male
  • Turkey / epidemiology