COMPARISON OF CLINICAL, LABORATORY FINDINGS AND COMPLICATIONS IN BACTERIEMIC AND NONBACTERIEMIC BRUCELLOSIS: A SINGLE CENTER EXPERIENCE

Yıl 2023, Cilt: 25 Sayı: 1, 10 - 15, 30.04.2023

Özlen Balta , Firdevs Aksoy , Nurten Nur Aydın , Medine Gözde Üstündağ , Seçuk Kaya , Gürdal Yılmaz , İftihar Köksal

https://doi.org/10.24938/kutfd.1086269

Öz

Objective: Brucellosis is a systemic zoonosis that affects various organs or body systems and can mimic many diseases. Symptoms can range from acute febrile illness to chronic clinical manifestations with severe complications. In our study, we investigated the relationship between bacteremia and clinical and laboratory findings, and complications in patients with brucellosis.
Material and Methods: Two hundred and twenty-three patients diagnosed with brucellosis between 2005 and 2020 in the department of infectious diseases and clinical microbiology of a tertiary care university hospital were included in the study. Rose Bengal test, Brucella standard tube agglutination test and culture (blood and/or bone marrow culture) were used for the diagnosis of brucellosis. The patients were divided into two groups according to their bacteremia status. Patients with positive culture were identified as bacteremia, and patients with negative culture were identified as non-bacteriemic.

Results: A total of 223 patients were included in the study, of which 142 (63.7%) were male. While weight loss, fever and hematological complications were higher in bacteremia cases (p=0.001, p<0.001, p=0.022, respectively), lumbar pain and skeletal system complications were higher in non-bacteremia cases (p=0.013, p<0.001, respectively).

Conclusion: In areas where Brucella is endemic, brucellosis should be ruled out in the presence of signs indicating malignancy such as fever, weight loss, and cytopenia.

Anahtar Kelimeler

Brucellosis, bacteriemia, complications

Bakteriyemik ve Bakteriyemik Olmayan Brusellozda Klinik, Laboratuvar Bulguları ve Komplikasyonların Karşılaştırılması: Tek Merkez Deneyimi

Öz

Amaç: Bruselloz, çeşitli organları veya sistemleri etkileyen ve birçok hastalığı taklit edebilen sistemik bir zoonozdur. Semptomlar, akut ateşli hastalıktan ciddi komplikasyonları olan kronik klinik belirtilere kadar değişebilir. Çalışmamızda brusellozlu hastalarda bakteriyemi ile klinik ve laboratuvar bulguları arasındaki ilişkiyi ve komplikasyonları araştırdık.
Gereç ve Yöntemler: 2005-2020 yılları arasında üçüncü basamak bir üniversite hastanesinde enfeksiyon hastalıkları ve klinik mikrobiyoloji anabilim dalında bruselloz tanısı alan 223 hasta çalışmaya dahil edildi. Bruselloz tanısı için Rose Bengal testi, Brucella standart tüp aglütinasyon testi ve kültür (kan ve/veya kemik iliği kültürü) kullanıldı. Hastalar bakteriyemi durumlarına göre iki gruba ayrıldı. Kan kültürü pozitif olan hastalar bakteriyemik, negatif kan kültürü olan hastalar bakteriyemik olmayan olarak tanımlandı.

Bulgular: Çalışmaya dahil edilen 223 hastanın 142’si (%63.7) erkekti. Bakteriyemik olgularda kilo kaybı, ateş ve hematolojik komplikasyonlar (sırasıyla p=0.001, p<0.001, p=0.022), bakteriyemik olmayan olgularda bel ağrısı ve iskelet sistemi komplikasyonları daha yüksekti (sırasıyla p=0.013, p<0.001).

Sonuç: Özellikle Brucella’nın endemik olduğu bölgelerde ateş, kilo kaybı ve sitopeni gibi maligniteye işaret eden bulguların varlığında bruselloz ekarte edilmelidir.

Anahtar Kelimeler

Bruselloz, bakteremi, komplikasyonlar

Kaynakça

• Corbel M. Brucellosis in humans and animals. 1st ed. Geneva. World Health Organization, 2006.
• Ulu Kilic A, Metan G, Alp E. Clinical Presentations and Diagnosis of Brucellosis. Recent Patents on Anti-Infective Drug Discovery. 2013;(8):34-41.
• Mermut G, Ozgenç O, Avcı M, Olut AI, Oktem E, Genc V et al. Clinical, Diagnostic and Therapeutic Approaches to Complications of Brucellosis: An Experience of 12 Years. Med Princ Pract. 2012;21(1):46-50.
• Kadanali A, Ozden K, Altoparlak U, Erturk A, Parlak M. Bacteremic and Nonbacteremic Brucellosis: Clinical and Laboratory Observations. Infection. 2009;37(1):67-9.
• Doganay M, Aygen B. Human brucellosis: an overview. Int J Infect Dis. 2003;7(3):173-82.
• Apa H, Devrim I, Memur S, Gunay I, Gulfidan G, Celegen M et al. Factors Affecting Brucella Spp. Blood Cultures Positivity in Children. Vector Borne Zoonotic Dis. 2013;13(3):176-80.
• Ben-Shimol S, Farahvar S, Fruchtman Y, Justman N. Factors Associated with Single and Recurrent Bacteremia in Childhood Brucellosis. J Pediatric Infect Dis Soc. 2020;9(6):664-70.
• Aypak A, Aypak C, Bayram Y. Hematological findings in children with brucellosis. Pediatrics International. 2015;57(6):1108-11.
• Kara SS, Cayir Y. Predictors of Blood Culture Positivity in Pediatric Brucellosis. J Coll Physicians Surg Pak. 2019;29(7):665-70.
• Qie C, Cui J, Liu Y, Li Y, Wu H, Mi Y. Epidemiological and clinical characteristics of bacteremic brucellosis. J Int Med Res. 2020;48(7):1-7.
• Kaya S, Elaldi N, Deveci O, Eskazan AE, Bekcibasi M, Hosoglu S. Cytopenia in adult brucellosis patients. Indian J Med Res. 2018;147(1):73-80.
• Demirdal T, Sen P. Risk factors for focal involvement in brucellosis. Diagn Microbiol Infect Dis. 2020;97(1):115003.
• Buzgan T, Karahocagil MK, Irmak H, Baran AI, Karsen H, Evirgen O et al. Clinical Manifestations and Complications in 1028 Cases of Brucellosis: A Retrospective Evaluation and Review of the Literature. Int J Infect Dis. 2010;14(6):469-78.
• Christaki E, Giamarellos-Bourboulis EJ. The Complex Pathogenesis of Bacteremia: From Antimicrobial Clearance Mechanisms to the Genetic Background of the Host. Virulence. 2014;5(1):57-65.
• Takizawa H, Manz MG. Impact of inflammation on early hematopoiesis and the microenvironment. Int J Hematol. 2017;106(1):27-33.