Sixteen Chinese pediatric brucellosis patients onset of fever in non-epidemic areas and 8 developed with osteoarticular involvement

Clin Rheumatol. 2018 Jan;37(1):145-149. doi: 10.1007/s10067-017-3819-y. Epub 2017 Sep 19.

Abstract

The purpose of this study is to summarize the manifestations, diagnosis, differential diagnosis, and treatment of childhood brucellosis in non-epidemic areas of China. A retrospective review of 16 admitted children patients with brucella's disease who were diagnosed of brucellosis during the period from 2011 to 2016 was performed. Diagnostic criteria, clinical presentations, and outcomes were recorded. The most common symptom was fever. Osteoarticular involvement was found in 50% of the patients. They were infected by contacting with infected animals or consuming of unpasteurized milk or meat of sheep or goats, also. Standard agglutination test was positive in all patients and blood culture in 10 (62.5%) patients as well as medulloculture in 3 (18.8%) patients were positive. A combination of antibiotic treatment with rifampin plus cotrimoxazole showed good response and all clinical manifestations improved. Brucellosis is misdiagnosed frequently and should be considered in the differential diagnosis when patients do not respond to standard treatment. Blood culture, together with brucella serology test, is important and helpful in the diagnosis. MRI is a good method in differentiating those with symptoms of arthritis.

Keywords: Brucella; Chinese children; Magnetic resonance; Misdiagnose; Osteoarticular.

MeSH terms

  • Adolescent
  • Agglutination Tests
  • Anti-Bacterial Agents / therapeutic use*
  • Brucellosis / diagnosis*
  • Brucellosis / drug therapy
  • Child
  • Child, Preschool
  • China
  • Diagnosis, Differential
  • Female
  • Fever / diagnosis*
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Rifampin / therapeutic use*
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Rifampin