Clinical features of seven patients with brucellosis from a non-endemic area: results of a retrospective analysis

Objective To investigate the epidemiological and clinical features of patients with brucellosis from a non-endemic area.Methods The epidemiological,clinical,laboratory and treatment data of patients with brucellosis during 2011 in the First Affiliated Hospital with Nanjing Medical University were retrospectively analyzed.Results All the patients had a history of close contact with sheep.The main clinical manifestations included of moderate to ardent fever,fatigue,anorexia,weight loss,arthralgia and respiratory symptoms,otherwise,sweating and hepatosplenomegaly were not very common.Meanwhile,one case showed relatively rare Parkinsonian-like tremor.T lymphocytes were upregulated and B lymphocytes were downregulated.Blood culture took a long time.Drug sensitivity test showed that Brucella were sensitive to trimethoprim-sulfamethoxazole,levofloxacin,tetracycline and amikacin,but were mostly resistant to cephalosporins.All the patients recovered after combination therapy with levofloxacin and trimethoprim-sulfamethoxazole.Conclusions Brucellosis has showed a trend of spreading to non-endemic areas and it should be taken into account if the patients with fever of unknown origin had a history of close contact with sheep,furthermore,we should pay attention to the uncommon clinical manifestations of respiratory injury and Parkinsonian-like tremor.Levofloxacin combined with trimethoprim-sulfamethoxazole may be suitable for anti-Brucella treatment. Key words: Brucellosis;  Epidemiology;  Signs and symptoms;  Diagnosis ;  Treatment