Examination of clinical, laboratory and epidemiological features of patients diagnosed brussellos

ABSTRACT Retrospective Evaluation of Adult Patients with Brucella Followed up in Dicle University Medical Faculty Hospital between 2017-2019 Objective: The present study included patients that were followed up in Dicle University Medical Faculty Infectious Diseases Department inpatient and/or outpatient clinics due to a diagnosis of brucellosis. The primary aim was to evaluate the relationship between brucella capture titer and blood culture positivity and to examine demographic, characteristics and clinical, laboratory, radiological findings of the patients as well as the treatment regimens administered in each patient. In addition, the departments to which the patients first applied and the rates of reporting the disease after diagnosis were also examined. Materials and Methods: Medical records of 214 patients diagnosed with brucellosis who were followed up in Dicle University Medical Faculty Infectious Diseases Department inpatient and/or outpatient clinics between January 2017 and December 2018 were retrospectively analyzed. Of these, 118 patients were included in the study. Rose bengal, brucella capture tests, and hemocultures of the patients were studied in the Dicle University Medical Faculty Infectious Diseases and Clinical Microbiology Laboratory, and other laboratory tests were performed in the Central Laboratory. Results: Patients comprised 59 (50%) men and 59 (50%) women with a mean age of 39.54 ± 17.123 years. While 58.5% of the patients lived in a rural area, 41.5% of the them lived in the city center. The two most common presenting symptoms were fever (89%) and bone-joint pain (73.7%). The two most common physical examination findings of the patients at the time of diagnosis were fever (89%) and tenderness in bones and joints (73.7%). An elevated erythrocyte sedimentation rate (ESR) was detected in 29.6% of patients, and an elevated C-reactive protein (CRP) was detected in 55.9% of patients. The two most common hematological findings at the time of diagnosis were anemia (45.8%) and lymphomonocytosis (26.3%) The two most common comorbidities were sacroiliitis (31.4%) and splenomegaly (25.4%). It was determined that 59.3% of the patients were notified about the disease, whereby the rate of notification was 64.7% in the clinics of infectious diseases and was 25% in the clinics of non-infectious diseases. Of all patients, 86.4% of them applied to the infectious diseases clinic. Among the patients applied to the clinics of non-infectious diseases, 50% of them applied to internal medicine, 31.25% to physical therapy-rehabilitation, 6.25% to urology, 6.25% to obstetrics, and 6.25% to psychiatry. Blood culture was taken from 56 (47.5%) out of 118 patients and 30 of them were found to be reproductive. All the microorganisms isolated from the culture specimens were B. Melitensis and 62.5% of the patients had a capture titer of 1280. It was also found that 31.25% of the patients with a titer of <1280 had reproduction in the blood culture. Conclusion: Patients with hematological findings such as anemia, leukopenia and thrombocytopenia due to brucellosis were found to have a significantly higher risk of developing sacroiliitis and splenomegaly (p<0.05).) As the brucella capture titer of the patients increased (from 1/320 to 1/5120), a statistically significant difference was found in the rate of isolation of brucella bacteria in blood culture (p <0.05). In our country, which is considered endemic in terms of brucellosis, patients that reside in rural areas and present with fever and a bone-joint pain should be diagnosed promptly and possible complications should be prevented by taking a detailed history of brucellosis. Accordingly, necessary awareness should be created and periodic trainings should be provided to ensure that physicians working in the clinics of non-infectious diseases have sufficient knowledge and skills in terms of diagnosis, treatment, and follow-up Key words: brucella, capture, blood culture, complication