Trends in Human Brucellosis: A 12-year Study of Admissions in a District Hospital
DOI:
https://doi.org/10.24950/rspmi/256/2017Keywords:
Brucellosis/diagnosis, Brucellosis/epidemiology, Brucellosis/therapyAbstract
Introduction: Human brucellosis can present various clinical
forms and potentially lead to an important social-economic
burden. High level of clinical suspicion and appropriate laboratory
testing interpretation are essential for the diagnosis.
The aim of this study was to review the admissions attributable
to brucellosis in a public hospital of an endemic region of Portugal.
Methods: Retrospective observational study of consecutive
hospital admissions with a discharge diagnosis of brucellosis
between 2000 and 2012, by the analysis of epidemiological,
clinical, laboratory and therapeutic features.
Results: A total of 36 patients were included. The percentage
of male patients was 69.4%, with mean age of 52.9 years old
and 72.2% presented a risk factor exposure for brucellosis.
We found 14 admissions in 2000 and zero admissions in 2012.
The most reported frequent symptoms were fever (72%), myalgia
(58.3%) and asthenia (47.2%). The rose bengal test was
positive for the majority of the tested patients (91.7%). On the
other hand, only one patient had a positive culture for brucellosis.
The disease was essentially acute (75%) and focalized
(69%). When focalized, osteoarticular involvement was
the most frequent presentation (37%). In univariate analysis,
patients who relapsed (16.6%) showed no significant association
with any of the epidemiologic, clinical, laboratory or
therapeutic features (p > 0.05). Antibiotic regimen most often
prescribed was rifampicin plus doxycycline (55.5%).
Conclusion: In our study, hospital admissions due to brucellosis
dropped dramatically between 2000 and 2012, which
shows an optimistic sign of disease control. Acute and focalized
forms of the disease were the most frequent manifestations
of this zoonosis that is still a challenge for clinicians.
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