Brucellosis: clinical analysis of 35 cases

Objective To analyze the clinical and laboratory data of brucellosis patients in Peking University Third Hospital, and to promote clinician's understanding and diagnosis and treatment of brucellosis, and to reduce misdiagnosis and missed diagnosis. Methods The clinical characteristics of patients with acute brucellosis in Peking University Third Hospital from January 1994 to December 2016 were retrospectively analyzed, including departments division, demographic characteristics, epidemiology, clinical manifestation, laboratory examination, diagnosis and treatment. Results There were 35 patients, 27 males and 8 females, with an average age of (46 ± 14) years. Patients with brucellosis were distributed in multiple departments of the hospital. There were 23 cases (65.7%) whose occupation were farmers or herdsmen, and 13 cases (37.1%) that lived in the outer suburbs of Beijing, and 19 cases in other provinces (54.3%). There were 18 cases having sheep (cattle) and pig contact history (51.4%). The main symptoms were fever in 35 cases (100.0%), the highest temperature was (39.42 ± 0.66)℃, other symptoms including muscle and joint pain (22, 62.9%), fatigue (16, 45.7%), sweating (13, 37.1%), hepatosplenomegaly (15, 42.9%) and lymphadenopathy (13, 37.1%). The positive rate of serum agglutination test was 62.9% (22/35), and the positive rate of blood culture was 65.7% (23/35). The course of disease was more than 30 d in 24 cases (68.6%). Multi-drug treatment was common before diagnosis; the cases were treated with doxycycline and rifampicin based, combined quinolone/ceftriaxone two, triple and quadruple therapy. After treatment for 4 days (1 - 6 days), the body temperature was returned to normal and the total course of treatment was 4 months (2 - 12 months). Twenty-five patients were followed up, and 23 cases had no recurrence. Conclusions In general hospital, brucellosis patients distributed in a number of departments, the conditions are relatively complex, a considerable number of patients do not have a clear epidemiological history, lack of specific clinical manifestations, the process of diagnosis and treatment is tortuous, and easily misdiagnosed. Doctors' understanding of brucellosis needs to be improved, in order to improve their level of diagnosis and treatment. Key words: Brucellosis; Clinical manifestations; Laboratory examination