Osteoarticular involvement of brucellosis in pediatric patients: clinical and laboratory characteristics
Background and objectives. The aim of this study was to evaluate the clinical and laboratory characteristics of osteoarticular involvement in children with brucellosis. Methods. A total of 202 pediatric brucellosis patients were evaluated from April 2012 to August 2013. Results. Among the 202 patients, 53 (26.2%) had osteoarticular involvement. In patients with osteoarticular involvement, the mean values of estimated sedimentation rate (ESR) and C-reactive protein (C-RP) were significantly higher than in patients without osteoarticular involvement (p = 0.001, p = 0.01, respectively). The majority of patients with osteoarticular involvement (n = 48, 90.6%) had a higher standard tube agglutination (STA) test titer (≥ 1/640) than patients without osteoarticular involvement (n = 69, 46.3%) (p = 0.001). The most commonly found osteoarticular involvement was peripheral arthritis. The second most commonly found osteoarticular involvement was sacroiliitis (n = 5, 9.4%). Three patients (5.7%) had spondylitis. Only one patient (1.9%) had osteomyelitis. Conclusions. Osteoarticular involvement was detected in nearly one of every four childhood brucellosis patients in our study. Brucellosis should be considered as a pre-diagnosis in children with osteoarticular complaints, especially in regions where the disease is endemic.
___
1. Pappas G, Papadimitriou P, Akriditis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis 2006; 6: 91-99.2. Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75: 195-211.
3. Republic of Turkey, Ministry of Health, Brucellosis statistical data for 1970-2004.
4. Kılıç S, Ivanov IN, Durmaz R, et al. Multiplelocus variable-number tandem-repeat analysis genotyping of human Brucella isolates from Turkey. J Clin Microbiol 2011; 49: 3276-3283.
5. Young EJ. Brucella species (Brucellosis). In: Long SS, Pickering LK, Prober CG (eds). Principles and Practice of Pediatric Infectious Diseases. (4th ed). New York: Elsevier, 2012: 861-865.
6. Al Shaalan M, Memish ZA, Al Mahmoud S, et al. Brucellosis in children: clinical observations in 115 cases. Int J Infec Dis 2002; 6: 182-186.
7. Gür A, Geyik MF, Dikici B, et al. Complications of brucellosis in different age groups: a study of 283 cases in southeastern Anatolia of Turkey. Yonsei Med J 2003; 44: 33-44.
8. Kennedy JC. Notes on case of chronic synovitis, or bursitis, due to organism of Mediterranean fever. J Roy Army Med Corps 1904; 2: 178-180.
9. Al-Eissa YA, Kambal AM, Alrabeeah AA, Abdullah AM, al-Jurayyan NA, al-Jishi NM. Osteoarticular brucellosis in children. Ann Rheum Dis 1990; 49: 896-900.
10. Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 2002; 132: 98- 105.
11. Dashti AS, Karimi A. Skeletal involvement of Brucella melitensis in children: a systematic review. Iran J Med Sci 2013; 38: 286-292.
12. Benjamin B, Annobil SH, Khan MR. Osteoarticular complications of childhood brucellosis: a study of 57 cases in Saudi Arabia. J Pediatr Orthop 1992; 12: 801-805.
13. Case definitions for infectious conditions under public health surveillance. Centers for Disease Control and Prevention. MMWR Recomm Rep 1997; 46: 1-55.
14. Gómez-Reino FJ, Mateo I, Fuertes A, Gómez-Reino JJ. Brucellar arthritis in children and its successful treatment with trimethoprim-sulphamethoxazole (co-trimoxazole). Ann Rheum Dis 1986; 45: 256-258.
15. Almuneef M, Memish ZA, Al Shaalan M, Al Banyan E, Al-Alola S, Balkhy HH. Brucella melitensis bacteremia in children: review of 62 cases. J Chemother 2003; 15: 76-80.
16. Mousa AR, Muhtaseb SA, Almudallal DS, Khodeir SM, Marafie AA. Osteoarticular complications of brucellosis: a study of 169 cases. Rev Infect Dis 1987; 9: 531-543.
17. Gotuzzo E, Seas C, Guerra JG, et al. Brucellar arthritis: a study of 39 Peruvian families. Ann Rheum Dis 1987; 46: 506-509.
18. Mantur BG, Akki AS, Mangalgi SS, Patil SV, Gobbur RH, Peerapur BV. Childhood brucellosis--a microbiological, epidemiological and clinical study. J Trop Pediatr 2004; 50: 153-157.
19. Roushan MRH, Ahmadi SAA, Gangi SMS, Janmohammadi N, Amiri MJS. Childhood brucellosis in Babol, Iran. Trop Doct 2005; 35: 229- 231.
20. Zamani A, Kooraki S, Mohazab RA, et al. Epidemiological and clinical features of Brucella arthritis in 24 children. Ann Saudi Med 2011; 31: 270-273.
21. el-Desouki M. Skeletal brucellosis: assessment with bone scintigraphy. Radiology 1991; 181: 415-418.
22. Tanir G, Tufekci SB, Tuygun N. Presentation, complications, and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009; 51: 114-119.
23. Parlak M, Akbayram S, Doğan M, et al. Clinical manifestations and laboratory findings of 496 children with brucellosis in Van, Turkey. Pediatr Int 2015; 57: 586-589.
24. Yoldas T, Tezer H, Ozkaya-Parlakay A, Saylı TR. Clinical and laboratory findings of 97 pediatric brucellosis patients in central Turkey. J Microbiol Immunol Infect 2015; 48: 446-449.
25. Çıraklı S, Karlı A, Şensoy G, Belet N, Yanık K, Çıraklı A. Evaluation of childhood brucellosis in the central Black Sea region. Turk J Pediatr 2015; 57: 123-128.
26. Bosilkovski M, Kirova-Urosevic V, Cekovska Z, et al. Osteoarticular involvement in childhood brucellosis: experience with 133 cases in an endemic region. Pediatr Infect Dis J 2013; 32: 815-819.
27. Alvarez de Bruego M, Gomez Reino FJ, Gomez Reino JJ. A long term study of 22 children with brucellar arthritis. Clin Exp Rheumatol 1990; 8: 609-612.
28. Lubani M, Sharda D, Helin I. Brucella arthritis in children. Infection 1986; 14: 233-236.
29. Issa H, Jamal M. Brucellosis in children in south Jordan. East Mediterr Health J 1999; 5: 895-902.
30. Benjamin B, Annobil SH. Childhood brucellosis in southwestern Saudi Arabia: a 5-year experience. J Trop Pediatr 1992; 38: 167-172.
31. Hashemi SH, Keramat F, Ranjbar M, Mamani M, Farzam A, Jamal-Omidi S. Osteoarticular complications of brucellosis in Hamedan, an endemic area in the west of Iran. Int J Infect Dis 2007; 11: 496-500.
32. Janmohammadi N, Roushan MRH. False negative serological tests may lead to misdiagnosis and mismanagement in osteoarticular brucellosis. Trop Doct 2009; 39: 88-90.
33. Galanakis E, Bourantas KL, Leveidiotou S, Lapatsanis PD. Childhood brucellosis in north-western Greece: a retrospective analysis. Eur J Pediatr 1996; 155: 1-6.
34. Al-Shamahy HA, Wright SG. A study of 235 cases of human brucellosis in Sana'a, Republic of Yemen. East Mediterr Health J 2001; 7: 238-246.
35. Shen MW. Diagnostic and therapeutic challenges of childhood brucellosis in a nonendemic country. Pediatrics 2008; 121: e1178-e1183.
36. Lifeso RM, Harder E, McCorkell SJ. Spinal brucellosis. J Bone Joint Surg Br 1985; 67: 345-351.
37. Nas K, Gür A, Kemaloğlu MS, et al. Management of spinal brucellosis and outcome of rehabilitation. Spinal Cord 2001; 39: 223-227.
38. al-Eissa YA, Kambal AM, al-Nasser MN, alHabib SA, al-Fawaz IM, al-Zamil FA. Childhood brucellosis: a study of 102 cases. Pediatr Infect Dis J 1990; 9: 74-79.
39. Logan LK, Jacobs NM, McAuley JB, Weinstein RA, Anderson EJ. A multicenter retrospective study of childhood brucellosis in Chicago, Illinois from 1986 to 2008. Int J Infect Dis 2011; 15: e812-e817.
40. Benjamin B, Khan MR. Hip involvement in childhood brucellosis. J Bone Joint Surg Br 1994; 76: 544-547.
- ISSN: 0041-4301
- Yayın Aralığı: Yılda 6 Sayı
- Başlangıç: 1958
- Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
Sayıdaki Diğer Makaleler
Tetanus; a forgotten infection disease: a report of two cases
Ülkem KOÇOĞLU BARLAS, Hasan Serdar KIHTIR, Osman YEŞİLBAŞ, Mey Talip PETMEZCİ, Nihal AKÇAY, Ercüment PETMEZCİ, Nevin HATİPOĞLU, Esra ŞEVKETOĞLU
Clinical manifestation and outcomes of children with hypertrophic cardiomyopathy in Kosovo
Ramush A. BEJIQI, Ragip RETKOCERI, Naim ZEKA, Armend VUÇİTERNA, Aferdita MUSTAFA, Arlinda MALOKU, Rinor BEJIQI
Performance of SNAPPE-II score in neonatal sepsis: an experience from a tertiary care center
Moumita SAMANTA, Chiranjib BISWAS, Nishith Kumar PAL, Soma SARKAR, Avranil GOSWAMİ, Avijit HAZRA, Arijit BHOWMİK, Tapas Kumar SABUI
Sinem Gülcan KERSİN, Turgut BOZAN, Hülya ÖZDEMİR, Hülya Selva BİLGEN, Güner SÖYLETİR, Aslı MEMİŞOĞLU, Eren ÖZEK
Çiğdem AKYOL BEYOĞLU, Pınar KENDİGELEN, İlhan BEYOĞLU, Fatiş ALTINDAŞ, Sebuh KURUĞOĞLU, Güner KAYA
Congenital afibrinogenemia in a 4-year-old girl complicated with acute lymphoblastic leukemia
Alper OZCAN, Bahadır SAMUR, Şefika AKYOL, Arda ERDOGMUS, Turkan PATIROGLU, MUSA KARAKÜKCÜ, Ekrem ÜNAL
Adem DURSUN, Serkan ÖZSOYLU, Başak AKYILDIZ
Aortic balloon valvuloplasty and mid-term results in newborns: a single center experience
Birgül VARAN, Kahraman YAKUT, İlkay ERDOĞAN, Murat ÖZKAN, Kürşad TOKEL
Maternal and fetal tuberous sclerosis complex: a case report questioning clinical approach
Özge Sürmeli ONAY, Adviye ÇAKIL SAĞLIK, Pelin KOSGER, Zeynep SARAÇOĞLU, Uğur TOPRAK, Birsen UCAR, AYŞE NESLİHAN TEKİN