Meltem Arzu YETKİN, Çiğdem ATAMAN HATİPOĞLU, Behiç ORAL, Sami KINIKLI, Ali Pekcan DEMİRÖZ, Gülruhsar YILMAZ, Fatma Şebnem ERDİNÇ, Necla TÜLEK, Cemal BULUT

Assessment of the findings on the existence of complications in brucellosis

Brucellosis is a prevalent disease in Turkey. The object of this study was to assess the findings in brucellosis cases with and without complications. Materials and methods: A total of 324 patients diagnosed with brucellosis between 1999 and 2005 were reviewed retrospectively. The diagnosis of brucellosis was established serologically and/or by positivite blood culture. Epidemiologic features, clinical symptoms, and laboratory findings of the patients were assessed in both complicated and noncomplicated brucellosis cases by univariate and multivariate analysis. Results: The mean age of patients was 44.0 ± 18.3 years (range 15-83 years). In addition, 56% of the patients were male. Animal husbandry (62.7%) and consumption of raw milk and/or fresh cheese (27.7%) were identified as being the main risk factors for brucellosis. Fever, malaise, sweating, and arthralgia were the most frequent clinical symptoms. The most common physical findings were fever, hepatomegaly, and splenomegaly. Complications were detected in 142 of 324 cases (43.8%). Osteoarticular involvement (25.9%) was the most common complication. Dealing with animal husbandry, living in a rural area, being between 31 years and 50 years of age, and an elevated C-reactive protein (CRP) level were significantly associated with the existence of complications by univariate analysis (P < 0.05). Elevated CRP level remained independently associated with complications by multivariate analysis (P < 0.05). Conclusion: Elevated CRP levels, in accordance with clinical manifestations of the patient, may be a sign of complications, and needs further investigation.

Anahtar Kelimeler:

Key words: Brucellosis, epidemiology, diagnosis, complication

Assessment of the findings on the existence of complications in brucellosis

Keywords:

Key words: Brucellosis, epidemiology, diagnosis, complication,

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Serra AJ, Godoy GP. Incidence, etiology and epidemiology of brucellosis in rural area of province of Lleida. Rev Esp Salud Publica 2000; 74: 45-53.
Almuneef MA, Memish ZA, Balkhy HH, Alotaibi B, Algado S, Abbas M et al. Importance of screening household members of acute brucellosis cases in endemic areas. Epidemiol Infect. 2004; 132: 533-40.
Colmenero JD, Reguera JM, Marthos F, Sanchez-De-Mora D, Delgado M, Causse M, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75: 195-211.
Solera J, Martinez-Alfaro E, Espinosa A. Recognition and optimum treatment of brucellosis. Drugs 1997; 53: 245-56.
Malik GM. A clinical study of brucellosis in adults in the Asiar region of southern Saudi Arabia. Am J Trop Med Hyg 1997; 56: 375-7.
Lulu AR, Araj GF, Khateeb MI, Mustafa MY, Yusuf AR, Fenech FF. Human brucellosis in Kuwait: a prospective study of 400 cases. Q J Med 1988; 66: 39-54. 16.
Namıduru M, Gungor K, Dikensoy O, Baydar I, Ekinci E,
Karaoglan I et al. Epidemiological, clinical and laboratory
features of Brucellosis: a prospective evaluation of 120 adult
patients. Int J Clin Pract 2003; 57: 20-4.
Taşova Y, Saltoğlu N, Şahin G, Aksu HS. Osteoarticular involvement of brucellosis in Turkey. Clin Rheumatol 1999; 18: 214-9.
Gotuzzo E, Alarkon GS, Bocanegra TS, Carrillo C, Guerra JC Rolondo I et al, Arthricular involvement in human brucellosis:a prospective analysis of 304 cases. Semin Arthritis Rheum 1982; 12: 245-55.
Gonzalez-Gay M, Garcia-Porrua C, İbanez D, Garcia-Pais MJ. Osteoarticular complications of brucellosis in an Atlantic area of Spain. J Rheumatol 1999; 26: 141-5.
McLean DR, Russell N, Khan MY. Neurobrucellosis: clinical and therapeutic features. Clin Infect Dis 1992; 15:582-90.
Bouza E, Garcia de la Torre M, Parras F, Guerrero A, Rodriguez- Creixems M, Gobernado J. Brucellar meningitis. Rev Infect Dis 1987; 9: 810-22.
Bodur H, Erbay A, Akinci E, Colpan A, Cevik MA, Balaban N. Neurobrucellosis in an endemic area of brucellosis. Scand J Infect Dis 2003; 35: 94-7.
Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Eng J Med 2005; 352: 2325-36.
Yetkin MA, Bulut C, Erdinç FS, Oral B, Tulek N. Evaluation of the clinical presentations in neurobrucellosis. Int J Infect Dis. 2006: 10; 446-52.
Yetkin MA, Erdinç FS, Bulut C, Tulek N. Epididymoorchitis due to brucellosis in central Anatolia, Turkey. Urol Int 2005; 75: 235- 8.
Hatipoglu CA, Bilgin G, Tulek N, Kosar U. Pulmonary involvement in brucellosis. J Infect 2005; 51: 116-9.
Al-KAssab AS, Nur MA, Malik JM. Evaluation of serum C- reactive protein in the diagnosis of arthritic and non-artritic brucellosis. J Trop Med Hyg 1991; 94: 92-6. 28. Yetkin, MA, Erdinc FS, Cevik MA, Ayan-Tumturk A, Tulek N. Complication rate and significance of serum C-reactive protein levels in brucellosis cases. Clin Microbiol Infect 2001; 7(suppl 1): 107.