Clinical and laboratory characteristics of 81 patients with brucellosis / 中华地方病学杂志

ABSTRACT

Objective:To analyze the clinical manifestations and laboratory features of brucellosis patients in order to provide help for clinical diagnosis.Methods:The medical records of confirmed brucellosis patients ( n=81) in Kunming Third People's Hospital from 2015 to 2019 were collected. The occupation, contact history, clinical manifestations, laboratory examination characteristics and treatment of the patients were retrospectively analyzed. Results:The 81 cases of brucellosis were mainly farmers (64 cases), most of who had a history of raising sheep or contacting sheep manure or secretions (71 cases). The clinical manifestations were fever (68 cases), low back pain (42 cases), joint pain (22 cases), including 72 cases in acute stage and 9 cases in chronic stage. Laboratory examination showed that liver function index total bilirubin (TB) and direct bilirubin (DB) were generally normal, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) were increased in about half of the patients; high sensitivity C-reactive protein (HsCRP), procalcitonin (PCT), interleukin-6 (IL-6) and serum amyloid A (SAA) were increased in more than 80% of the patients, and erythrocyte sedimentation rate (ESR) was increased in 64.6% (42/65) of the patients. Doxycycline plus rifampicin was the first-line treatment program.Conclusion:The clinical manifestations of patients with brucellosis are diverse and atypical, and patients with nonspecific clinical manifestations such as fever should be combined with their occupation, contact history, indicators of infection detection, timely blood culture examination to make a clear diagnosis, and patients with abnormal liver function should pay attention to asking about occupation and contact history, so as to reduce misdiagnosis and mistreatment of brucellosis.