Retrospective analysis of clinical, laboratory findings, treatment results and complication rates of brucellosis cases

Retrospective Analysis of Clinical, Laboratory Findings, Treatment Results and Complication Rates of Brucellosis Cases Objective: In this research, it was aimed to determine the demographic and clinical characteristics, laboratory findings, treatments and treatment results, and complication rates of patients diagnosed with brucellosis who were followed up in Erzincan Binali Yıldırım University Mengücek Gazi Training and Research Hospital Infectious Diseases and Clinical Microbiology service and/or outpatient clinic. Material and Methods: The files of 291 patients whom applied to our in- and outpatient clinic and diagnosed as brucellosis between January 2014 and December 2019 were analyzed retrospectively. Cases were evaluated in terms of their distibution by age and gender, history of fresh milk and dairy product consumption, animal husbandry history, complaints on admission, duration of complaints, physical examination and laboratory findings, diagnosis and treatment methods. All cases are diagnosed by clinical signs and positive standard tube agglutination test (≥1/160 titers or 4-fold increase in titer in double serum samples taken at least two weeks apart) and/ or a positive blood culture. Data obtained in the study were analyzed by using SPSS (Statistical Package for Social Sciences) for Windows 25.0 program. Chi-square analysis was performed for categorical data. In the comparison of two groups, statistical evaluation in variables that do not fit the normal distribution were examined by Mann Whitney U test. Results: 148 (50,9%) of 291 cases participating in the study were male; 143 of them (49,1%) were female. Average age was calculated as 45,25 ± 15,82. The most frequent possible transmission route was detected as contact with infected animals and consumption of fresh milk and dairy products. The most common symptoms were joint pain, weakness, and fever. It was determined that the patients mostly applied in the summer months. A statistically significant correlation was found between clinical classification and serum CRP levels (p <0,05); clinical classification and positive blood culture (p <0,05). While the complication rate was 18,9% , the most common complication was musculoskeletal involvement. There was no statistically significant xii relationship between genders and complication rates (p >0,05). The most common complications were genitourinary system involvement in men and musculoskeletal involvement in women. There was no statistically significant difference between development of complications and relapse (p>0,05). Doxycycline and rifampicin treatment was given most frequently. The relapse rate was 9,6%. The mean time to relapse was calculated as 5,22 ± 3,27 months. There was no statistically significant relationship between clinical classification and relapse occurrence (p > 0,05). Conclusion: Brucellosis is seen as endemic in our country. It can present with a wide clinical range from asymptomatic illness to sepsis. Although there are nonspesific laboratory findings, differential diagnosis should be made when investigating the etiology of leukopenia, thrombocytopenia and anemia in our region. Considering its morbidity, mortality and sequelae results, early diagnosis-treatment and detection of organ involvement are very important.