2009-2019 Yılları Arasında Sivas Cumhuriyet Üniversitesi Tıp Fakültesi Çocuk Kliniği’nde Bruselloz Saptanan Çocuk Hastaların Demografik, Klinik, Laboratuvar Bulguları ve Tedavilerinin Değerlendirilmesi

Abstract

Purpose: The purpose of the present study is to evaluate the demographical and clinical characteristics, laboratory findings, all symptoms, treatments received, durations of hospital stay and prognosis after treatment of the pediatric patients with brucellosis diagnosis followed-up in the Pediatrics Department of the Research and Application Hospital of Sivas Cumhuriyet University. Materials and Methods: In this study, 51 patients within the age group 0 and 18, who were diagnosed with brucellosis and who presented to the Pediatrics Department of Research and Application Hospital of Sivas Cumhuriyet University between January 1st, 2009 and December 31st, 2019, were included. The files of the patients were analyzed retrospectively. The diagnosis was made in all patients with the presence of history, clinical symptoms and findings by the positivity (≥1/160) of the Standard Tube Agglutination Test (STA) and/or by the growth of Brucella species in the blood culture. The time the patients who were included in the study presented to the hospital, their ages, gender, place of residence, intake of raw milk and dairy products, contact history with farm animals, time elapsed until diagnosis, Brucella history in the other members of the family, the properties of their houses, the number of people living in the house, social insurance, physical examination findings, laboratory findings, all symptoms of the patient, treatments received, duration of hospital stay, complications and prognosis after treatment were examined and recorded. Findings: 41 of the patients (80.4%) were males and 10 of them (19.6%) were females. The ages of the patients were between 2 and 17, and the average age was 10.9±4.10. The time it took between the patients’ onset of complaints and the diagnosis of brucellosis varied between 1 and 30 days, and the average number of days was 10. The most frequent complaint was fever which was seen in 39 (76.5 %) patients. The second most frequent complaint was joint pain observed in 34 (66.7 %) patients. 15 (29.4 %) of the patients presented with fever and 12 (23.5 %) patients had joint swelling. Statistically significant difference was observed between the Erythrocyte Sedimentation Rates (ESH), C-Reactive Protein (CRP) values before and after the treatment (p=0.001, p=0.002). Before the treatment, Platelets (PLT), Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) were significantly high (p=0.010, p=0.000, p=0.000). Conclusion: Because Turkey is an endemic zone for Brucellosis, Brucellosis must be considered for every child with complaints of long-lasting fever, perspiration and joint pain. Both clinical and serological evaluations of the family members of the patient with brucellosis diagnosis might be needed. This would enable the early diagnosis and treatments of probable cases. Diagnosis and treatment of the disease in the early stage, awareness-raising in public against consuming raw milk and/or dairy products in places where animal breeding is prevalent, especially in the rural areas, training of the public and the health personnel on the causes of Brucellosis transmission and the methods of protection from Brucellosis would be the precautions to be protected from this infection and would lead to a reduction in the development of complications.