Clinical profile of brucellosis from a tertiary care center in southern India

摘要

Objective:To highlight the spectrum of clinical manifestations,labs,complications,treatment and outcome of brucellosis.Methods:Retrospective study was conducted in Kasturba Medical College,Manipal University,Karnataka,India which included 68 confirmed cases of brucellosis from January 2006- April 2010.Diagnosis of brucellosis was made by culturing the sera/body fluids by standard BACTEC method(or) by testing the sera for Brucella agglutinins using the standard agglutination test(SAT).A titer of 1:320 or more was considered as significant.SPSS 16 was used for statistical analysis and Microsoft Excel for graphical representation.Results:Of the 68 patients,46(68%) were male and 22(32%) were female patients with age distribution of 9-75 years.Forty four(64.7%) had history of contact with unpasteurized dairy products or infected animals.Symptoms included fever(68,100%),myalgia(21,31%),musculoskeletal symptoms (23,34%),headache(16,24%),gastrointestinal symptoms(19,28%) and altered sensorium(3, 4%).Co-morbidities and associations included HIV positivity(2,3%),type 2 diabetes mellitus (13,19%),steroid therapy(3,4%) and HBsAg positivity(8,12%).Ten(15%) patients had cervical lymphadenopathy,4(6%) had splenic enlargement,6(7%) had hepatomegaly,19(28%) had hepatosplenomegaly and 2(3%) got meningeal signs.Anaemia was observed in 39(57.3%) cases,high erythrocyte sedimentation rate(ESR) was present in 55(80.8%) cases,leucocytosis in 10(14.7%),leucopenia in 10(14.7%),thrombocytopenia in 23(33.82%) and thrombocytosis in 2(2.94%) cases.Conclusions:In countries like India,where brucellosis and tuberculosis are endemic;rapid,sensitive and highly specific diagnostic methods are required to make early diagnosis and prevent resistance as there is an overlap in therapy.