An Outbreak of Brucellosis: An Adult and Pediatric Case Series.

Autor: Hassouneh L; Department of Pediatrics, Division of Pediatric Infectious Diseases UT Southwestern, Dallas, Texas.; Warren Alpert Medical Brown University, Providence, Rhode Island., Quadri S; Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, UT Southwestern, Dallas, Texas.; Franciscan Physician Network, Hammond, Indiana., Pichilingue-Reto P; Department of Pediatrics, Division of Pediatric Infectious Diseases UT Southwestern, Dallas, Texas., Chaisavaneeyakorn S; Department of Pediatrics, Division of Pediatric Infectious Diseases UT Southwestern, Dallas, Texas.; St. Jude Children's Research Hospital, Memphis, Tennessee., Cutrell JB; Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, UT Southwestern, Dallas, Texas.; VA North Texas Healthcare System, Dallas., Wetzel DM; Department of Pediatrics, Division of Pediatric Infectious Diseases UT Southwestern, Dallas, Texas., Nijhawan AE; Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, UT Southwestern, Dallas, Texas.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2019 Aug 30; Vol. 6 (10), pp. ofz384. Date of Electronic Publication: 2019 Aug 30 (Print Publication: 2019).
DOI: 10.1093/ofid/ofz384
Abstrakt: Background: Brucellosis is recognized as a neglected zoonotic disease and a major public health threat. The purpose of this study was to characterize epidemiological risk factors and healthcare utilization and compare clinical aspects of disease among adult and pediatric cases in North Texas.
Methods: A retrospective chart review of electronic medical records was completed at 3 large tertiary centers-Parkland Health and Hospital System, Clements University Hospital, and Children's Medical Center-between January 1, 2007 and June 1, 2017. Demographic, clinical, and laboratory variables were collected. Cases were defined as confirmed or probable.
Results: Twenty-eight cases of brucellosis were identified: 26 confirmed (9 children, 17 adults) and 2 probable cases (1 child, 1 adult). Half (n = 14) were diagnosed in 2016 during an outbreak in Dallas County. Risk factors associated with infection were consumption of unpasteurized cheese (71%), recent travel (54%), close contact to a confirmed human brucellosis case (36%), and exposure to animals (11%). Median days of symptoms was 10 and 16 for children and adults, respectively. The majority (79%) of patients visited the emergency department before diagnosis and 93% were hospitalized. Fever was the most common symptom in children (80%) and adults (100%). Hepatitis (75% of children) and anemia (82% of adults) were the most common laboratory abnormalities. The most common complication in children was splenic lesions (40%), and the most common complication in adults was hepato/splenomegaly (39%).
Conclusions: The diagnosis of Brucella infection requires a high index of suspicion and should be considered in patients presenting with a febrile illness and a compatible exposure history.
(© The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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