Download PDF
J Pediatr Infect Dis 2022; 17(06): 289-296
DOI: 10.1055/s-0042-1757881
Original Article

Sibling Screening in Pediatric Brucellosis

Seval Özen 
1   Medical Faculty, Department of Pediatric Infectious Diseases, Adiyaman University, Adiyaman, Turkey
,
Fatih Üçkardeş
2   Department of Biostatistics and Medical Informatics, Adiyaman University, Adiyaman, Turkey
,
Curet Alev
3   Adiyaman Research and Training Hospital, Medical Microbiology, Adiyaman, Turkey
,
Hatice Uygun
1   Medical Faculty, Department of Pediatric Infectious Diseases, Adiyaman University, Adiyaman, Turkey
,
Nurettin Erdem
1   Medical Faculty, Department of Pediatric Infectious Diseases, Adiyaman University, Adiyaman, Turkey
,
Mehmet Turgut
1   Medical Faculty, Department of Pediatric Infectious Diseases, Adiyaman University, Adiyaman, Turkey
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objective Routine screening of household members of index cases is a priority in regions where brucellosis is endemic. This study aimed to identify seropositive and seronegative pediatric patients by screening the siblings of our pediatric patients diagnosed with brucellosis (index cases) and to investigate the relationships among these groups by comparatively evaluating their demographic, epidemiological, clinical, and laboratory characteristics.

Methods Eighty-five pediatric household members of 59 pediatric patients diagnosed with acute brucellosis were evaluated. A total of 144 children were included in the study.

Results Among 85 pediatric household members, 34 (40%) children were seropositive and 51 (60%) were seronegative. The predominant clinical symptom was arthralgia (81.4%), and the main finding was abnormal liver function tests (LFTs). The most frequent osteoarticular involvement was monoarticular arthritis (88%). Index cases and seropositive patients showed significantly greater elevations in LFTs compared with seronegative patients (p < 0.001 and p < 0.001). C-reactive protein values of index cases and seropositive patients were significantly higher compared with seronegative patients (p < 0.001 and p = 0.001). Neutrophil and platelet counts of index cases were significantly lower than those of seronegative patients (p = 0.017 and p = 0.002). Index cases and seropositive patients were given treatment, and after follow-up of at least 1 year, none of the seropositive patients relapsed, but relapse occurred in nine (15.3%) children from the index group. Two (3.9%) seronegative patients were diagnosed with acute brucellosis.

Conclusion Additional cases of brucellosis can be detected by screening household members of index cases in endemic areas. Elevations in LFTs when detected early in the asymptomatic period may provide a clue for brucellosis.

Keywords

brucellosis - screening - seropositive asymptomatic - index case


Publication History

Received: 03 April 2022

Accepted: 05 September 2022

Article published online:
19 October 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Young EJ. Brucella species (brucellosis). In: Long SS, Prober CG, Fischer M. eds. Principles and Practice of Pediatric Infectious Disease. 5th ed.. Philadelphia: Elsevier; 2018: 4555-4573
    Search in Google Scholar
  • 2 Republic of Turkey, Ministry of Health, Brucellosis statistical data for 2008–2017. Available at: https://hsgm.saglik.gov.tr/tr/zoonotikvektorel-bruselloz/istatistik
    PubMed
  • 3 Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis 2006; 6 (02) 91-99
    CrossrefPubMedSearch in Google Scholar
  • 4 Young EJ. Brucellosis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ. eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed.. Philadelphia: Elsevier; 2019: 1156-1159
    Search in Google Scholar
  • 5 American Academy of Pediatrics. Brucellosis. In: Kimberlin DW, Brady MT, Jackson MA, Long SS. eds. 2018 Report of the Committee on Infectious Diseases. 31st ed.. Itasca, IL: American Academy of Pediatrics; 2018: 255-257
    Search in Google Scholar
  • 6 Almuneef MA, Memish ZA, Balkhy HH. et al. Importance of screening household members of acute brucellosis cases in endemic areas. Epidemiol Infect 2004; 132 (03) 533-540
    CrossrefPubMedSearch in Google Scholar
  • 7 Tabak F, Hakko E, Mete B, Ozaras R, Mert A, Ozturk R. Is family screening necessary in brucellosis?. Infection 2008; 36 (06) 575-577
    CrossrefPubMedSearch in Google Scholar
  • 8 Ismayilova R, Mody R, Abdullayev R. et al. Screening of household family members of brucellosis cases and neighboring community members in Azerbaijan. Am J Trop Med Hyg 2013; 88 (05) 929-931
    CrossrefPubMedSearch in Google Scholar
  • 9 Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol 2007; 25 (03) 188-202
    CrossrefPubMedSearch in Google Scholar
  • 10 Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance. MMWR Recomm Rep 1997; 46 (RR-10): 1-55
    PubMedSearch in Google Scholar
  • 11 Agin M, Kayar Y. Demographic, laboratory, and clinical comparison of pediatric brucella cases with and without liver involvement. Cureus 2020; 12 (10) e10862
    PubMedSearch in Google Scholar
  • 12 Nicholson JF, Pesce MA. Reference ranges for laboratory tests. In: Behrman RE, Kliegman RM, Nelson WE, Vaughan VC. eds. Nelson Textbook of Pediatrics. 14th ed.. Philadelphia: WB Saunders; 2000: 1799-1826
    Search in Google Scholar
  • 13 Long SS, Vodzak J. Laboratory manifestations of infectious diseases. In: Long SS, Prober CG, Fischer M. eds. Pediatric Infectious Diseases. 5th ed.. Philadelphia: Elsevier; 2018: 7518-7519
    Search in Google Scholar
  • 14 Çetinkaya F, Naçar M, Aydin T, Koç N, Gökahmetoğlu S. Prevalence of brucellosis in the rural area of Kayseri, Central Anatolia, Turkey. Int J Infect Dis 2006; 10 (02) 179-181
    CrossrefPubMedSearch in Google Scholar
  • 15 Yumuk Z, O'Callaghan D. Brucellosis in Turkey—an overview. Int J Infect Dis 2012; 16: 228-235
    CrossrefPubMedSearch in Google Scholar
  • 16 Gotuzzo E, Carrillo C, Seas C, Guerra J, Maguiña C. Epidemiological and clinical features of brucellosis in 39 family groups [in Spanish]. Enferm Infecc Microbiol Clin 1989; 7 (10) 519-524
    PubMedSearch in Google Scholar
  • 17 Shaalan MA, Memish ZA, Mahmoud SA. et al. Brucellosis in children: clinical observations in 115 cases. Int J Infect Dis 2002; 6 (03) 182-186
    CrossrefPubMedSearch in Google Scholar
  • 18 Zamani A, Kooraki S, Mohazab RA. et al. Epidemiological and clinical features of Brucella arthritis in 24 children. Ann Saudi Med 2011; 31 (03) 270-273
    CrossrefPubMedSearch in Google Scholar
  • 19 Tanir G, Tufekci SB, Tuygun N. Presentation, complications, and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009; 51 (01) 114-119
    CrossrefPubMedSearch in Google Scholar
  • 20 Sharda DC, Lubani M. A study of brucellosis in childhood. Clin Pediatr (Phila) 1986; 25 (10) 492-495
    CrossrefPubMedSearch in Google Scholar
  • 21 Yoldas T, Tezer H, Ozkaya-Parlakay A, Sayli TR. Clinical and laboratory findings of 97 pediatric brucellosis patients in central Turkey. J Microbiol Immunol Infect 2015; 48 (04) 446-449
    CrossrefPubMedSearch in Google Scholar
  • 22 Imdat D, Durmus A, Karahocagil MK. et al. Hematological complications in 787 cases of acute brucellosis in eastern Turkey. Turk J Med Sci 2008; 38: 421-424
    PubMedSearch in Google Scholar
  • 23 Zheng R, Xie S, Lu X. et al. A systematic review and meta-analysis of epidemiology and clinical manifestations of human brucellosis in China. BioMed Res Int 2018; 2018: 5712920
    CrossrefPubMedSearch in Google Scholar
  • 24 Karaman K, Akbayram S, Bayhan GI. et al. Hematologic findings in children with brucellosis: experiences of 622 patients in eastern Turkey. J Pediatr Hematol Oncol 2016; 38 (06) 463-466
    CrossrefPubMedSearch in Google Scholar
  • 25 Colmenero JD, Reguera JM, Martos F. et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75 (04) 195-211
    CrossrefPubMedSearch in Google Scholar
  • 26 Solera J. Treatment of human brucellosis. J Med Liban 2000; 48 (04) 255-263
    PubMedSearch in Google Scholar
  • 27 Hu J, Zhang X, Yang H. et al. Brucellosis screening and follow-up of seropositive asymptomatic subjects among household members of shepherds in China. Eur J Clin Microbiol Infect Dis 2021; 40 (06) 1325-1328
    CrossrefPubMedSearch in Google Scholar
  • 28 Corbel MJ, Beeching NJ. Brucellosis. In: Kasper DL, Braunwald E, Fauci A. eds. Harrison's Principles of Internal Medicine. 17th ed.. USA: McGrawHill Medical; 2008: 547-552
    Search in Google Scholar
  • 29 Eales KM, Norton RE, Ketheesan N. Brucellosis in northern Australia. Am J Trop Med Hyg 2010; 83 (04) 876-878
    CrossrefPubMedSearch in Google Scholar
  • 30 Kayaaslan B, Bastug A, Aydin E. et al. A long-term survey of brucellosis: is there any marker to predict the complicated cases?. Infect Dis (Lond) 2016; 48 (03) 215-221
    CrossrefPubMedSearch in Google Scholar
  • 31 Demiroğlu YZ, Turunç T, Alişkan H, Colakoğlu S, Arslan H. [Brucellosis: retrospective evaluation of the clinical, laboratory and epidemiological features of 151 cases [in Turkish]. Mikrobiyol Bul 2007; 41 (04) 517-527
    PubMedSearch in Google Scholar
  • 32 Nimri LF. Diagnosis of recent and relapsed cases of human brucellosis by PCR assay. BMC Infect Dis 2003; 3: 5
    CrossrefPubMedSearch in Google Scholar