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Endemik olduğu bir bölgeden 83 olgu ile brusella enfeksiyonu

Amaç: Brusella enfeksiyonu; dünya genelindeki en yaygın bakteriyel zoonoz olup ülkemizde de yüksek görülme oranları ile bir halk sağlığı sorunu olmaya devam etmektedir. Biz de çalışmamızda brusellozun ülkemizde sık görüldüğü bölgelerden biri olan Şırnak ilindeki olguları irdeledik. Gereç ve Yöntem: İkinci basamak bir hastanenin enfeksiyon hastalıkları ve klinik mikrobiyoloji polikliğine Ekim 2017- Aralık 2018 tarihleri arasında başvuran, ayaktan ve yatarak takip edilen 83 brusella ile enfekte hastanın olası risk faktörleri, başvuru şikayetleri, şikayetlerin başlama zamanı, klinik bulguları, gelişen komplikasyonları ve başlanan tedavileri retrospektif olarak incelendi. Bulgular: Çalışmaya alınan 83 hastanın %61,4’ü (51/83) kadındı. Hastaların yaş ortalaması 35,3 (15-84) saptandı. Brusella enfeksiyonuna en çok ev hanımlarında rastlandı (%39,7) ve en yaygın risk faktörü taze peynir tüketimi idi (%78,3). En sık görülen semptom ise yaygın kas ve eklem ağrısı idi. İkili ve üçlü kombinasyonlar şeklinde 13 farklı tedavi rejimi uygulandı, hastaların %13,2’sinde çeşitli nedenlerle tedavi değişikliği yapıldı. Brusella ile enfekte hastaların %30,1’inde hepatit, %13,2’sinde kemik eklem tutulumu saptandı. Osteoartiküler tutulumu olanlarda; eritrosit sedimantasyon hızı (p=0,009) ve C reaktif protein (p=0,046) yüksekliği, olmayanlara göre istatistiksel olarak anlamlı saptandı. Üç hastada (%3,6) ise epididmoorşit gelişmişti. Hastaların %26,5’inde relaps görüldü. Sonuç: Özellikle bölgemiz gibi brusella enfeksiyonunun yaygın olarak görüldüğü yerlerde nonspesifik semptom ve bulgular ile başvuran hastalarda mutlaka brusella enfeksiyonu akılda tutulmalı ve hastalar bruselloz açısından tetkik edilmelidir.

Anahtar Kelimeler:

Bruselloz, komplikasyonlar, relaps

Eighty-three cases of brucella infection from an endemic region

Aim: Brucellosis is the most common bacterial zoonosis in all around the world and still a public health threat with high rates of incidence in Turkey. In the present study, we evaluated the brucella infection cases, manifested in Sirnak, one of the regions that brucellosis is common in our country. Materials and Methods: We retrospectively collected data of 83 outpatients and inpatients who admitted infectious disease department of a second-line hospital between dates of October 2017 and December 2018. We have evaluated possible risk factors for brucellosis, complaints of the patients, the initiation time of the complaints, clinical signs, complications and treatment regimes. Results: 61.4% (51/83) of the patients included in the study were female. The mean age of the patients was 35.3 (15-84). Brucella infection was most common among housewives (39.7%) and the most common risk factor was fresh dairy cheese consumption (78.3%). The most common symptom was muscle and joint pain. We have applied 13 different treatment regimens in the form of double and triple drug combinations, and treatment of 13.2% of the patients was switched because of various reasons. 30.1% of the patients infected with brucella had hepatitis and 13.2% had osteoarticular involvement. Erythrocyte sedimentation rate (p = 0.009) and C reactive protein (p = 0.046) were statistically significant high in patients with osteoarticular involvement compared to without. The correlation between higher Erythrocyte sedimentation rate (p = 0.009), C reactive protein (p = 0.046) values and osteoarticular involvement was statistically significant. Epididymoorchitis was developed in three patients (3,6%). The rate of relapse was 26.5%. Conclusion: Brucella infection should be kept in mind in patients presenting with nonspecific symptoms, especially in areas where brucella infection is common like our region and patients should be examined for brucellosis.

Keywords:

Brucellosis, complications, relapse,

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