Clinical Features and Long Term Prognosis of Childhood Brucellosis in Northeast Iran|
Sasan, Mohammad-Saeed; Nateghi, Malihe; Bonyadi, Behrooz & Aelami, Mohammad-Hassan
Objective: Brucellosis is a prevalent disorder in children of developing countries. The aim of this study is to
describe the epidemiology and long term prognosis of Brucellosis in Khorasan, Iran.
Methods: This is a descriptive cross sectional study (from November 2003 up to February 2006), the subjects
of which are composed of 82 patients (from Imam Reza hospital, Mashhad, and Health Center of Kashmar). In
this study the diagnosis of Brucellosis is based on serology accompanied with clinical signs and symptoms.
Our strategy for duration of treatment was to treat all patients for at least 6 weeks. We followed the patients
by phone and if necessary by visiting.
Findings: During 38 months we had 82 children with Brucellosis. The mean age was 8.02 y, and 40% of them
were girls (M/F=1.21). Summer with 45.9% of the cases was the peak season. History of consuming raw dairy
products, close contact with farm animals, living in village and Brucellosis in family was found in 91.6%, 76%,
70.24% and 41.1% of the cases respectively. The presenting symptom in 79.7% of the cases was joint pain,
72.9% had history of fever during the course of the disease. Arthritis, splenomegaly and lymphadenopathy
were found in 60.97%, 16.9%, 7.5%, of patients respectively. The therapeutic regimen of 48.7% of our
patients was Co-trimoxazole and rifampin. We followed 74% of the patients for at least 3 years which showed
the relapse rate of 6.5 %. There was a case of reinfection, a patient with residual sequel and one death related
to Brucellosis in our case series.
Conclusion: Brucellosis is still a common disease in our children and at least a risk factor for it can be found in
the history of almost all cases of pediatric Brucellosis. With at least six weeks treatment with two antibiotics
and with close follow up, we can decrease the relapse rate in pediatric Brucellosis to zero, even without
repeating the serology during or after treatment.
Brucellosis; Children; Prognosis; Epidemiology