RESUMO
Brucellosis is a zoonotic disease that mimics many other diseases, making diagnosis difficult in pediatric patients. If the clinical signs of the disease are not well known and there is a delay in diagnosis and treatment, complicated brucellosis involving different body sites can develop. This study aimed to analyze the demographics, clinical information, laboratory test results, and imaging findings of children with brucellosis. Particular attention was paid to the involvement of organs and potential complications. Pediatric patients diagnosed with brucellosis at the Sanliurfa Training and Research Hospital in Turkey were retrospectively evaluated. In total, 101 patients diagnosed with brucellosis were included in this study. Bone-joint involvement was observed in 21 (20.7%) patients. High Brucella Coombs gel test (CT) titers (≥1/640) and increased erythrocyte sedimentation rate (ESR) were significant in the bone-joint brucellosis group (P = 0.022 and P = 0.0205, respectively). Fourteen (13.9%) patients had at least one organomegaly in which Brucella CT titers and C-reactive protein (CRP) levels were substantially higher than those in patients without organomegaly (P = 0.02 and P = 0.0049, respectively). Anemia, leukopenia, and thrombocytopenia were observed in 36 (35.6%), 10 (9.9%), and 4 (3.9%) patients, respectively. At least one elevation in liver function test (LFT) results was observed in 32 (31.7%) patients. High acute-phase reactants, such as ESR, CRP levels, and Brucella CT titers, may help identify complicated brucellosis. This study highlights that pediatric brucellosis can lead to cytopenia and elevated LFT results and should therefore be considered as a differential diagnosis.
RESUMO
Clavicle duplication is a rare entity with limited number of cases reported. Congenital origin and trauma related mechanisms are the main hypotheses to explain this anatomical variation. In skeletally immature patient, trauma may cause physeal-metaphyseal injury in the distal clavicle rather than acromioclavicular strain. The distal epiphysis remains in continuity with acromion and has an intact periosteal sleeve. The periosteal sleeve is extremely osteogenic, and may lead to new bone formation between epiphysis and displaced metaphysis. This remodeling potential and the intact acromioclavicular joint allow the children to be followed by closed reduction. However, there can be new bone formation between epiphysis and displaced metaphysis, resulting in clavicle duplication. Herein, we present the radiographic and computed tomography findings of a post-traumatic duplication of the clavicle in a 5-year-old boy.
