Journal of Child

SUBMITINFORMATION
EnglishTürkçe

Research Article


DOI :10.26650/jchild.2020.3.819575   IUP :10.26650/jchild.2020.3.819575    Full Text (PDF)

Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization

Ayşe Büyükçam

Objective: Human brucellosis is a systemic disease that mimics many diseases, and its diagnosis is extremely difficult in children. Childhood brucellosis may present with serious clinical pictures and cause complications. This study aimed to investigate the characteristics of childhood brucellosis and the diagnostic role of laboratory markers for hospitalization. Material and Methods: Sixty children aged between 0 and 18 years who were diagnosed with brucellosis between January 1, 2018 and December 31, 2019 were evaluated retrospectively. The demographic characteristics and clinical, microbiological, and other laboratory findings of brucellosis patients who were followed up as outpatient and inpatient were examined. Results: The median age of the patients was 9.3±4.3 years; 41.7% were girls and 58.3% were boys. Joint involvement was 83.3% of the patients. Total 33.3% patients were hospitalized. The median value of blood serum eosinophil counts was 60/µL (10-90/µL) in hospitalized patients and 110/ µL (55-205/µL) in outpatients (p=0.022). For blood eosinophil count cutoff level ≤ 90/µL (confidence interval [CI] 95%, 54.4-93.9), sensitivity was 78.95% (Cl 95%, 54.4-93.9) and specificity was 60%, (Cl 95%, 43.3-75.1). Conclusion: Childhood brucellosis remains an important public health problem for our country. Blood eosinophil levels may have a role in indicating the degree of disease and deciding hospitalization in childhood brucellosis. New studies with more patients are needed to understand this relationship better and to evaluate its specificity and sensitivity.

Keywords: Brucellosis, child, blood eosinophil count
DOI :10.26650/jchild.2020.3.819575   IUP :10.26650/jchild.2020.3.819575    Full Text (PDF)

Çocukluk Çağı Bruselloz Özellikleri ve Hastaneye Yatışta Laboratuvar Belirteçlerinin Tanısal Rolü

Ayşe Büyükçam

Amaç: İnsan brusellozu, birçok hastalığı taklit eden sistemik bir hastalıktır ve çocuklarda da teşhis edilmesi çok zor olabilmektedir. Çocukluk çağı brusellozu, ciddi klinik tablolarla karşımıza gelebilir ve komplikasyonlara neden olabilir. Bu çalışmada, çocukluk çağı bruselloz hastalarının özellikleri ile hastaneye yatışta laboratuvar belirteçlerin tanısal rolünün araştırılması amaçlandı. Gereç ve Yöntemler: Geriye dönük olarak 1 Ocak 2018 ile 31 Aralık 2019 tarihleri arasında bruselloz tanısı alan 0-18 yaş 60 çocuk hasta değerlendirildi. Ayaktan ve hastaneye yatış verilerek izlenen bruselloz hastalarının demografik özellikleri ve klinikleri ile mikrobiyolojik ve diğer laboratuvar bulguları incelendi. Bulgular: Hastaların yaş ortalaması, 9.3±4.3 yıldı ve %41,7’si kız, %58,3’ü erkek idi. Hastaların %83,3’ünde eklem tutulumu mevcuttu. Hastaların %33,3’ü yatırılarak izlendi. Kan serum eozinofil sayıları yatan hastalarda ortanca değeri 60/µL (10-90/µL) iken ayaktan hastalarda 110/µL (55-205/ µL) değerleri arasında idi (p=0,022). Kan eozinofil sayısı kesme seviyesi ≤90/µL için; (CI %95, 54,4-93,9) duyarlılık %78,95 (Cl %95, 54,4-93,9) ve özgüllük %60,00, (Cl %95,43,3-75,1) olarak bulundu. Sonuç: Çocukluk çağı brusellozu ülkemiz için önemli bir halk sağlığı sorunu olmaya devam etmektedir. Kan eozinofil düzeyleri, çocukluk çağı brusellozunda hastalık derecesini göstermede ve yatışa karar vermede bir role sahip olabilir ama bu ilişkinin daha iyi anlaşılması, özgüllük ve duyarlılığının değerlendirmesi için daha fazla sayıda hasta ile yeni çalışmalara ihtiyaç vardır.

Keywords: Bruselloz, çocuk, kan eozinofil sayısı

PDF View

References

  • 1. Bukhari EE. Pediatric brucellosis. An update review for the new millennium. Saudi Med J 2018 Apr;39(4):336-41. google scholar
  • 2. Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005 Jun 2;352(22):2325-36. google scholar
  • 3. CDC. Brucellosıs reference guıde: Exposures, testıng, and preventıon. 2017 [cited 2020]; Available from: https://www.cdc. gov/brucellosis/pdf/brucellosi-reference-guide.pdf. google scholar
  • 4. Downes KJ. Brucella. In: Robert M. Klıegman M, Joseph W. St Geme III M, Nathan J. Blum M, Samır S. Shah M, MSCE, Robert C. Tasker M, MD, Karen M. Wılson M, MPH, et al., editors. Nelson Texbook of Pediatrics. 21 ed. p. 6199-206. google scholar
  • 5. Hanefi C. Gul, Erdem H. Brucellosis ( Brucella Species). In: John E. Bennett MD, Raphael Dolin MD, MD MJB, editors. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, . 9 ed2020. p. 2753-8.e2. google scholar
  • 6. Seleem MN, Boyle SM, Sriranganathan N. Brucellosis: a reemerging zoonosis. Vet Microbiol 2010 Jan 27;140(3-4):392-8. google scholar
  • 7. Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis 2006 Feb;6(2):91-9. google scholar
  • 8. T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Türkiye Bruselloz İstatistik Verileri. 2017 [cited 2020]; Available from: hsgm.saglik.gov.tr/tr/zoonotikvektorel-bruselloz/istatistik. google scholar
  • 9. Young EJ. Brucellosis. In: James D. Cherry MD M, Gail J. Harrison MD, Sheldon L. Kaplan MD, William J. Steinbach MD, Peter J. Hotez MD P, editors. Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. 8 ed2019. p. 1156-9.e3. google scholar
  • 10. Erdem H, Elaldi N, Ak O, Gulsun S, Tekin R, Ulug M, et al. Genitourinary brucellosis: results of a multicentric study. Clinical microbiology and infection: The official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2014 Nov;20(11):O847-53. google scholar
  • 11. Klinik, Bakteriyoloji, Tanı, Standartları, Çalışma, Grubu. Brusellozun Mikrobiolojik tanısı. 2015 [cited 2020]; Available from: https:// hsgm.saglik.gov.tr/depo/birimler/Mikrobiyoloji_Referans_ Laboratuvarlari_ve_Biyolojik_Urunler_DB/rehberler/UMS_ LabTaniRehberi_Cilt_1.pdf. google scholar
  • 12. CDC. Brucellosis-Serology. 2012 [cited 2020]; Available from: https://www.cdc.gov/brucellosis/clinicians/serology.html. google scholar
  • 13. al-Eissa Y, al-Zamil F, al-Mugeiren M, al-Rasheed S, al-Sanie A, al- Mazyad A. Childhood brucellosis: a deceptive infectious disease. Scand J Infect Dis 1991;23(2):129-33. google scholar
  • 14. Kazanasmaz H, Geter S. Investigation of the sensitivity and specificity of laboratory tests used in differential diagnosis of childhood brucellosis. Cureus. 2020 Jan 23;12(1):e6756. google scholar
  • 15. Arapovic J, Spicic S, Ostojic M, Duvnjak S, Arapovic M, Nikolic J, et al. Epidemiological, clinical and molecular characterization of human brucellosis in Bosnia and Herzegovina - An ongoing brucellosis outbreak. Acta Med Acad 2018 May;47(1):50-60. google scholar
  • 16. Olt S, Ergenc H, Acikgoz SB. Predictive contribution of neutrophil/ lymphocyte ratio in diagnosis of brucellosis. Biomed Res Int 2015;2015:210502. google scholar
  • 17. Bozdemir ŞE, Altıntop YA, Uytun S, Aslaner H, Torun YA. Diagnostic role of mean platelet volume and neutrophil to lymphocyte ratio in childhood brucellosis. Korean J Intern Med 2017 Nov;32(6):1075-81. google scholar
  • 18. Aypak A, Aypak C, Bayram Y. Hematological findings in children with brucellosis. Pediatr Int 2015 Dec;57(6):1108-11. google scholar
  • 19. Tanir G, Tufekci SB, Tuygun N. Presentation, complications, and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009 Feb;51(1):114-9. google scholar
  • 20. Citak EC, Citak FE, Tanyeri B, Arman D. Hematologic manifestations of brucellosis in children: 5 years experience of an anatolian center. J Pediatr Hematol Oncol 2010 Mar;32(2):137-40. google scholar
  • 21. Okan DH, Gökmen Z, Seyit B, Yuksel K, Cevdet Z, Deniz A. Mean platelet volume in brucellosis: correlation between brucella standard serum agglutination test results, platelet count, and C-reactive protein. Afr Health Sci 2014 Dec;14(4):797-801. google scholar
  • 22. Küçükbayrak A, Taş T, Tosun M, Aktaş G, Alçelik A, Necati Hakyemez I, et al. Could thrombocyte parameters be an inflammatory marker in the brucellosis? Med Glas (Zenica) 2013 Feb;10(1):35-9. google scholar
  • 23. Aktar F, Tekin R, Bektas MS, Güneş A, Köşker M, Ertuğrul S, et al. Diagnostic role of inflammatory markers in pediatric Brucella arthritis. Ital J Pediatr 2016 Jan 11;42:3. google scholar
  • 24. Okur M, Erbey F, Bektaş MS, Kaya A, Doğan M, Acar MN, et al. Retrospective clinical and laboratory evaluation of children with brucellosis. Pediatr Int 2012 Apr;54(2):215-8. google scholar
  • 25. Downes KJ. Brucella. In: Robert M. Klıegman M, Joseph W. St Geme III M, Nathan J. Blum M, Samır S. Shah M, MSCE, Robert C. Tasker M, MD, Karen M. Wılson M, MPH, et al., editors. Nelson Texbook of Pediatrics. 21 ed2020. p. 6199-206. google scholar
  • 26. Benjamin L. Wright, Vickery BP. Eosinophils. In: Robert M. Klıegman M, Joseph W. St Geme III M, Nathan J. Blum M, Samır S. Shah M, MSCE, Robert C. Tasker M, MD, Karen M. Wılson M, MPH, et al., editors. Nelson Text Book. 21 ed2020. p. 4739-48. google scholar
  • 27. O’Connell EM, Nutman TB. Eosinophilia in infectious diseases. Immunol Allergy Clin North Am 2015 Aug;35(3):493-522. google scholar
  • 28. Butt NM, Lambert J, Ali S, Beer PA, Cross NC, Duncombe A, et al. Guideline for the investigation and management of eosinophilia. Br J Haematol 2017 Feb;176(4):553-72. google scholar
  • 29. Karakonstantis S, Kalemaki D, Tzagkarakis E, Lydakis C. Pitfalls in studies of eosinopenia and neutrophil-to-lymphocyte count ratio. Infect Dis (Lond) 2018 Mar;50(3):163-74. google scholar
  • 30. Gil H, Bouldoires B, Bailly B, Meaux Ruault N, Humbert S, Magy- Bertrand N. L’éosinopénie en 2018 [Eosinopenia in 2018]. Rev Med Interne 2019 Mar;40(3):173-7. google scholar

Citations

Copy and paste a formatted citation or use one of the options to export in your chosen format


EXPORT



APA

Büyükçam, A. (2020). Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization. Journal of Child, 20(3), 89-95. https://doi.org/10.26650/jchild.2020.3.819575


AMA

Büyükçam A. Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization. Journal of Child. 2020;20(3):89-95. https://doi.org/10.26650/jchild.2020.3.819575


ABNT

Büyükçam, A. Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization. Journal of Child, [Publisher Location], v. 20, n. 3, p. 89-95, 2020.


Chicago: Author-Date Style

Büyükçam, Ayşe,. 2020. “Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization.” Journal of Child 20, no. 3: 89-95. https://doi.org/10.26650/jchild.2020.3.819575


Chicago: Humanities Style

Büyükçam, Ayşe,. “Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization.” Journal of Child 20, no. 3 (Apr. 2024): 89-95. https://doi.org/10.26650/jchild.2020.3.819575


Harvard: Australian Style

Büyükçam, A 2020, 'Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization', Journal of Child, vol. 20, no. 3, pp. 89-95, viewed 25 Apr. 2024, https://doi.org/10.26650/jchild.2020.3.819575


Harvard: Author-Date Style

Büyükçam, A. (2020) ‘Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization’, Journal of Child, 20(3), pp. 89-95. https://doi.org/10.26650/jchild.2020.3.819575 (25 Apr. 2024).


MLA

Büyükçam, Ayşe,. “Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization.” Journal of Child, vol. 20, no. 3, 2020, pp. 89-95. [Database Container], https://doi.org/10.26650/jchild.2020.3.819575


Vancouver

Büyükçam A. Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization. Journal of Child [Internet]. 25 Apr. 2024 [cited 25 Apr. 2024];20(3):89-95. Available from: https://doi.org/10.26650/jchild.2020.3.819575 doi: 10.26650/jchild.2020.3.819575


ISNAD

Büyükçam, Ayşe. “Features of Childhood Brucellosis and the Diagnostic Role of Laboratory Markers in Hospitalization”. Journal of Child 20/3 (Apr. 2024): 89-95. https://doi.org/10.26650/jchild.2020.3.819575



TIMELINE


Submitted01.11.2020
Accepted14.12.2020
Published Online30.12.2020

LICENCE


Attribution-NonCommercial (CC BY-NC)

This license lets others remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.


SHARE




Istanbul University Press aims to contribute to the dissemination of ever growing scientific knowledge through publication of high quality scientific journals and books in accordance with the international publishing standards and ethics. Istanbul University Press follows an open access, non-commercial, scholarly publishing.