Clinical analysis on 45 children with brucellosis in non-pastoral areas

Objective To investigate the epidemiological, clinical and laboratory characteristics of children with brucellosis, and to provide evidence for its diagnosis in non-pastoral areas. Methods Clinical data of 45 children with brucellosis in non-pastoral areas from Shaanxi Provincial Center for Diseases Control and Prevention, and Xi’an Children’s Hospital from January 2014 to December 2018 were analyzed, retrospectively, and the clinical characteristics and laboratory examinations were summarized and analyzed, respectively. Results The incidence of childhood brucellosis in non-pastoral areas peaked from March to September, and the incidence of childhood brucellosis increased year by year from 2014 to 2018. Among the 45 children, 19 were males and 26 were females. Children aged 0-3 years were the main group with brucellosis in non-pastoral areas (53.3%, 24/45). The main route of transmission was digestive tract transmission (64.4%, 29/45). Children with brucellosis had various clinical manifestations, the main clinical manifestations were fever (82.2%, 37/45), followed by joint swelling and pain (40.0%, 18/45) and hepatomegaly (28.9%, 13/45), while hyperhidrosis (11.1%, 5/45) and fatigue (6.7%, 3/45) were rare. Inflammation indexes were the main abnormal factos in laboratory examination, procalcitonin increased in 30 cases (66.7%), the erythrocyte sedimentation rate (ESR) increased in 10 cases (22.2%), C-reactive protein (CRP) increased in 7 cases (15.6%); no child occurred decreased total number of whole blood cells in routine examination. Among the 45 children, 35 (77.8%) cases were Brucella positive in blood culture and 10 (22.2%) cases were positive in test tube agglutination detection. Symptoms of nervous system involvement were found among 4 cases (8.9%), and Brucella was cultured in cerebrospinal fluid of the above 4 cases. Conclusions The clinical manifestations of children with brucellosis are complex . In non-pastoral areas, when children had long-term fever, joint swelling and pain, and liver enlargement, pediatricians should be highly suspicious of brucellosis and make early diagnosis and timely treatment. Key words: Brucellosis; Clinical characteristics; Non-pastoral areas; Child