1195. Comparative Analysis Between Acute and Sub-Acute Brucellosis

Abstract

Abstract Background Brucellosis remains a public health problem. Its myriad and non-specific manifestations vary according to the clinical presentation. We aimed to compare the clinical and laboratory features between acute and sub-acute brucellosis. Methods We conducted a retrospective study including all patients hospitalized for acute and sub-acute brucellosis in the infectious disease department between 1992 and 2020. Results We encountered 104 patients (50.2%) with acute brucellosis and 103 patients (49.8%) with sub-acute brucellosis. Patients with sub-acute brucellosis were significantly older (45.1±17.2 years vs 36.5±17.5 years; p< 0.001). Male gender represented 64.4% of acute brucellosis cases and 67% of sub-acute brucellosis cases (p=0.6). Night sweats (78.8% vs 65%; p=0.027), myalgia (34.6% vs 21.4%; p=0.034) and asthenia (70.2% vs 45.6%; p< 0.001) were significantly more frequent among acute brucellosis cases. Back pain was significantly more frequent among sub-acute brucellosis cases (78.6% vs 28.8%; p< 0.001). Fever (89.4% vs 83.5%; p=0.2), weight loss (29.8% vs 32.4%; p=0.6) and arthralgia (56.7% vs 51.5%; p=0.4) were noted among acute and sub-acute brucellosis group, with no significant difference. Lymph nodes were significantly more frequent among acute brucellosis cases (15.5% vs 1.9%; p=0.002). Splenomegaly (13.5% vs 6.8%; p=0.1) and hepatomegaly (6.7% vs 5.8%; p=0.7) were more frequent among acute brucellosis group, with no significant difference. Laboratory investigations revealed leukopenia (21.2% vs 8.7%; p=0.012) and thrombocytopenia (19.2% vs 7.8%; p=0.016), which were significantly more frequent among acute brucellosis group. While elevated C-reactive protein levels were more frequent among sub-acute brucellosis group (52.4% vs 39.4%; p=0.06), elevated liver enzymes were more frequent among acute brucellosis group (38.8% vs 23.1%; p=0.087), with no significant difference. The mean duration of hospitalization was longer among sub-acute brucellosis cases (16±11 days vs 7±4 days; p< 0.001). Conclusion The presence of sweating, myalgia and asthenia associated with leukopenia and thrombocytopenia was suggestive of acute brucellosis, while back pain, especially among the elderly, was suggestive of sub-acute brucellosis. Disclosures All Authors: No reported disclosures