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Shi QN, Qin HJ, Lu QS, Li S, Tao ZF, Fan MG, Aishan MH, Kou ZQ, Chen QL, Yin WW, Zhang YP. Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China. Infect Dis Poverty 2024; 13:18. [PMID: 38374211 PMCID: PMC10877768 DOI: 10.1186/s40249-024-01186-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Brucellosis is a severe zoonotic disease that is often overlooked, particularly in impoverished countries. Timely identification of focal complications in brucellosis is crucial for improving treatment outcomes. However, there is currently a lack of established indicators or biomarkers for diagnosing these complications. Therefore, this study aimed to investigate potential warning signs of focal complications in human brucellosis, with the goal of providing practical parameters for clinicians to aid in the diagnosis and management of patients. METHODS A multi-center cross-sectional study was conducted in China from December 2019 to August 2021. The study aimed to investigate the clinical characteristics and complications of patients with brucellosis using a questionnaire survey and medical record system. The presence of warning signs for complications was assessed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used for variable screening and model evaluation. RESULTS A total of 880 participants diagnosed with human brucellosis were enrolled. The median age of the patients was 50 years [interquartile range (IQR): 41.5-58.0], and 54.8% had complications. The most common organ system affected by complications was the osteoarticular system (43.1%), with peripheral arthritis (30.0%), spondylitis (16.6%), paravertebral abscess (5.0%), and sacroiliitis (2.7%) being the most prevalent. Complications in other organ systems included the genitourinary system (4.7%), respiratory system (4.7%), and hematologic system (4.6%). Several factors were found to be associated with focal brucellosis. These factors included a long delay in diagnosis [odds ratio (OR) = 3.963, 95% confidence interval (CI) 1.906-8.238 for > 90 days], the presence of underlying disease (OR = 1.675, 95% CI 1.176-2.384), arthralgia (OR = 3.197, 95% CI 1.986-5.148), eye bulging pain (OR = 3.482, 95% CI 1.349-8.988), C-reactive protein (CRP) > 10 mg/L (OR = 1.910, 95% CI 1.310-2.784) and erythrocyte sedimentation rate (ESR) elevation (OR = 1.663, 95% CI 1.145-2.415). The optimal cutoff value in ROC analysis was > 5.4 mg/L for CRP (sensitivity 73.4% and specificity 51.9%) and > 25 mm/h for ESR (sensitivity 47.9% and specificity 71.1%). CONCLUSIONS More than 50% of patients with brucellosis experienced complications. Factors such as diagnostic delay, underlying disease, arthralgia, eye pain, and elevated levels of CRP and ESR were identified as significant markers for the development of complications. Therefore, patients presenting with these conditions should be closely monitored for potential complications, regardless of their culture results and standard tube agglutination test titers.
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Affiliation(s)
- Qing-Nan Shi
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Changbai Road, Changping District, Beijing, 102206, China
| | - Hui-Jie Qin
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Qiao-Shan Lu
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Shu Li
- Nanning Center for Disease Control and Prevention, Nanning, China
| | - Zhong-Fa Tao
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Meng-Guang Fan
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Mu-Heta Aishan
- Xinjiang Uighur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Zeng-Qiang Kou
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Qiu-Lan Chen
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Changbai Road, Changping District, Beijing, 102206, China.
| | - Wen-Wu Yin
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Changbai Road, Changping District, Beijing, 102206, China.
| | - Yan-Ping Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Changbai Road, Changping District, Beijing, 102206, China
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Ma H, Yang Y, Liu H, Sun X, Li Y, Guo M. Brucella-infected abdominal aortic aneurysm: management strategies for an uncommon aneurysm. Front Med (Lausanne) 2023; 10:1271217. [PMID: 38020135 PMCID: PMC10652764 DOI: 10.3389/fmed.2023.1271217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Objective The occurrence of Brucella-induced abdominal aortic aneurysms is an exceedingly rare phenomenon, yet it stands as one of the most severe complications within this context. The combined utilization of serological testing and imaging diagnostics has been validated as an effective approach for the identification of Brucella-induced abdominal aortic aneurysms. Presently, the predominant therapeutic strategies encompass antibiotic treatment and surgical intervention. Nonetheless, ongoing controversies persist concerning the establishment of diagnostic criteria, the optimal timing and selection of antibiotic regimens, and the nuanced decision between open surgical procedures and endovascular interventions. Through a meticulous analysis of cases originating from our institution as well as a comprehensive review of previously documented instances, we aim to engage in a detailed discourse on the salient diagnostic and therapeutic facets surrounding Brucella-induced abdominal aortic aneurysms. Methods We conducted a retrospective summary of three cases involving Brucella-induced abdominal aortic aneurysms treated within our institution. Furthermore, we performed a comprehensive PubMed search, without imposing restrictions on language or publication year, to identify pertinent literature pertaining to Brucella-induced abdominal aortic aneurysms. The selection criteria primarily focused on case reports delineating occurrences of abdominal aortic aneurysms attributed to Brucella infection. Results We present three distinct cases of Brucella-induced abdominal aortic aneurysms managed at our institution, providing comprehensive insights into the employed diagnostic and therapeutic approaches. Additionally, over the past five decades, a total of 24 cases in 23 publications of Brucella-induced abdominal aortic aneurysms have been reported on PubMed. The earliest report dates back to 1976. Conclusion Our analysis suggests that Brucella-induced abdominal aortic aneurysm is characterized by a remarkably low incidence but is associated with a substantial risk of life-threatening complications. The integration of serological and imaging assessments assumes pivotal importance in facilitating prompt diagnosis of this condition. The prompt initiation of targeted antibiotic therapy is recommended, and the selection of appropriate surgical strategies should be guided by considerations including aneurysm dimensions and morphological attributes. The timely identification and intervention carry utmost significance in retarding disease advancement and ameliorating unfavorable clinical outcomes.
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Affiliation(s)
- Huibo Ma
- Department of Vascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yuling Yang
- Department of Infectious Diseases, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Huanhuan Liu
- Department of General Surgery, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Xiaozhi Sun
- Department of Vascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yongxin Li
- Department of Vascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Mingjin Guo
- Department of Vascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Qin S, Lv D, Duan R, Zheng X, Bukai A, Lu X, Duan Q, Yu M, Jing H, Wang X. Case report: A case of brucellosis misdiagnosed as coronavirus disease 2019/influenza in China. Front Public Health 2023; 11:1186800. [PMID: 37724314 PMCID: PMC10505428 DOI: 10.3389/fpubh.2023.1186800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/14/2023] [Indexed: 09/20/2023] Open
Abstract
Brucellosis is an important zoonosis and a multisystem disease. The signs and symptoms of brucellosis are not specific. In the clinical, brucellosis is often ignored and misdiagnosed. We report a case of brucellosis who was misdiagnosed as coronavirus disease 2019 (COVID-19)/influenza and received delayed treatment during strict COVID-19 control. The neglect of other diseases due to COVID-19 and empirical diagnosis and treatment by medical staff are part of the reasons for misdiagnosis. Otherwise, the normal erythrocyte sedimentation rate (ESR), increased white blood cell count (WBC), and increased neutrophil count (NEUT) of this patient was also a cause of misdiagnosis, which is an important reminder for diagnosis. For patients with the unknown origin of fever and other symptoms related to brucellosis, especially those from endemic areas of brucellosis, brucellosis screening is a priority item, and grassroots doctors should be vigilant and standardize the diagnosis and treatment based on epidemiology history, clinical manifestation, and laboratory tests according to the diagnostic criteria of brucellosis.
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Affiliation(s)
- Shuai Qin
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongyue Lv
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ran Duan
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaojin Zheng
- Akesai Kazak Autonomous County Center for Disease Control and Prevention, Jiuquan, China
| | - Asaiti Bukai
- Akesai Kazak Autonomous County Center for Disease Control and Prevention, Jiuquan, China
| | - Xinmin Lu
- Akesai Kazak Autonomous County Center for Disease Control and Prevention, Jiuquan, China
| | - Qun Duan
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mingrun Yu
- Taizhou Center for Disease Control and Prevention, Taizhou, China
| | - Huaiqi Jing
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin Wang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Zhang Z, Zhang X, Chen X, Cui X, Cai M, Yang L, Zhang Y. Clinical Features of Human Brucellosis and Risk Factors for Focal Complications: A Retrospective Analysis in a Tertiary-Care Hospital in Beijing, China. Int J Gen Med 2022; 15:7373-7382. [PMID: 36157291 PMCID: PMC9507445 DOI: 10.2147/ijgm.s380328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/29/2022] [Indexed: 01/18/2023] Open
Abstract
Purpose Brucellosis is an ongoing zoonotic disease in China, but there are few data in Beijing. This study was designed to illustrate clinical characteristics of patients with brucellosis in Beijing, China and explore the risk factors for focal brucellosis. Patients and Methods Data of patients with brucellosis were retrospectively collected from the patients’ electronic medical records in Beijing Youan Hospital during 2010 to 2021, including epidemiological, demographic and clinical features. Risk factors for focal brucellosis were identified by multivariable logistic regression models. Results A total of 197 patients were included in the study, with 165 (83.8%) cases in acute phase and 32 (16.2%) cases in chronic phase. Patients in acute phase were more likely to have splenomegaly (24.2% vs 3.1%, p=0.007) than those in chronic phase, but had less arthralgia (62.4% vs 81.3%, p=0.040). The median level of alanine aminotransferase (36.9 vs 20.7, p=0.001) was higher in patients at acute stage than those at chronic stage. Of all the patients, 76 (38.6%) were reported with focal complications, including 16 (8.1%) peripheral arthritis, 36 (18.3%) spondylitis, 17 (8.6%) epididymoorchitis, 8 (4.1%) meningitis and 3 (1.3%) endocarditis. Additionally, male (OR 2.76, 95% CI 1.15–6.64, p = 0.023), arthralgia (OR 6.23, 95% CI 2.36–16.43, p < 0.001) and higher level of platelets (OR 1.01, 95% CI 1.00–1.01, p < 0.001) were the independent risk factors for focal brucellosis. Conclusion The control of human brucellosis still cannot be ignored due to the re-emerging cases in Beijing, which are more likely to present splenomegaly and abnormal liver function in acute phase. Moreover, male, arthralgia and high level of platelets were the independent risk factors for focal brucellosis.
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Affiliation(s)
- Zhili Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xin Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xue Chen
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiao Cui
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Miaotian Cai
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Liu Yang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yulin Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Correspondence: Yulin Zhang, Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China, Tel +86 10-83997143, Fax +86 10-63293371, Email
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Copur B, Sayili U. Laboratory and clinical predictors of focal involvement and bacteremia in brucellosis. Eur J Clin Microbiol Infect Dis 2022; 41:793-801. [PMID: 35364783 DOI: 10.1007/s10096-022-04436-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
Abstract
Early diagnosis of organ involvement and bacteremia in brucellosis increases treatment success and may prevent poor clinical outcomes. This study aimed to investigate the predictors of focal involvement and bacteremia in patients with brucellosis. A total of 139 brucellosis patients aged 16 years and older were included in the study. Patients with and without organ involvement and bacteremic and non-bacteremic patients were compared separately. Low back pain, lymphadenomegaly, absence of fever on admission, ESR, AST, and neutrophil-lymphocyte ratio (NLR) were predictors of focal involvement (OR: 2.604; 3.167; 7.224; 1.039; 1.032; 1.738, respectively). The AUC value of ESR was 0.669 (0.573-0.765, p = 0.002) with the cutoff point > 30 mm/h (sensitivity 89.74% and specificity 37.00%) in predicting focal involvement in patients with brucellosis. Myalgia and headache (OR: 2.970; 2692) were defined as clinical predictors of Brucella bacteremia. Focal involvement should be considered in patients with brucellosis in the absence of myalgia and fever, presence of low back pain, and sedimentation > 30 mm/h. Brucella bacteremia should be considered regardless of fever, especially in patients with myalgia and headache in endemic areas.
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Affiliation(s)
- Betul Copur
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Sultangazi, Istanbul, Turkey.
| | - Ugurcan Sayili
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Department of Biostatistics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Wang J, Li S, Zhang Q. Brucellar Knee Arthritis with Knee Joint Tuberculosis: A Case Report and Review of the Literature. Infect Drug Resist 2022; 15:1659-1665. [PMID: 35422641 PMCID: PMC9004727 DOI: 10.2147/idr.s359693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/26/2022] [Indexed: 11/23/2022] Open
Abstract
Brucella and Mycobacterium tuberculosis (MTB) primarily affect the spine and only rarely the knee joint in osteoarticular disease in adults. We present an unusual instance of brucellar knee arthritis combined with knee joint tuberculosis. A 59-year-old man was initially diagnosed with brucellar knee arthritis in the orthopedics department of our hospital, while two weeks of standardized treatment did not improve the joint discomfort and inflammation indexes. Subsequent evaluation of serum tuberculosis interferon-gamma release assays (TB-IGRAs) and the effectiveness of empirical anti-tuberculosis therapy confirmed the mixed infection of tuberculosis. This case report demonstrates that clinical signs and imaging for brucellar knee arthritis and knee joint tuberculosis are similar. Patients with both disorders are more likely to be misdiagnosed or have their diagnosis delayed; clinicians should be aware of this uncommon combination of mixed infections.
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Affiliation(s)
- Jie Wang
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Shuguang Li
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Qiang Zhang
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
- Correspondence: Qiang Zhang, Email
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Li X, Wang T, Wang Y, Xie S, Tan W, Li P. Short- and long-term follow-up outcomes of patients with Brucella endocarditis: a systematic review of 207 Brucella endocarditis Cases. Bioengineered 2021; 12:5162-5172. [PMID: 34405766 PMCID: PMC8806701 DOI: 10.1080/21655979.2021.1962683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Brucella endocarditis is a fatal complication and the most frequent cause of death for human brucellosis. This study aimed to systematically review the literature on the follow-up outcomes of Brucella endocarditis and analyze the determinants affecting the follow-up outcomes. The databases PubMed, Web of Science, Embase, and Cochrane were searched using keywords and suitable combinations. All studies reporting the follow-up outcomes of Brucella endocarditis were included. Finally, a total of 76 studies (207 patients), including cases or case series, were included. The event rate for patients who underwent short- and long-term follow-up was 12.0% (2 relapsed and 1 died) and 8.1% (6 relapsed and 8 died), respectively. The differences in outcomes between different age groups (18–39, 40–59, and ≥60) were significant (P < 0.05, P = 0.035). The outcomes of the 18–39 age group were worse than those of the 40–59 age group (OR, 0.277; 95% CI, 0.103–0.748; P = 0.011). Accordingly, follow-up (both short- and long-term follow-up) is essential for Brucella endocarditis patients, especially for younger patients (18–39 years) in the first 6 months after treatment. The burden of Brucella endocarditis related complications were immense. Further studies are needed to explore age-based epidemiology of Brucella endocarditis and the exact influencing factors of the follow-up outcomes.
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Affiliation(s)
- Xiufeng Li
- Department of Nursing, School of Medicine, Shihezi University, Shihezi, China
| | - Tan Wang
- Department of Nursing, School of Medicine, Shihezi University, Shihezi, China
| | - Yuanzhi Wang
- Department of Basic Medicine, School of Medicine, Shihezi University, Shihezi, China
| | - Songsong Xie
- Department of Infectious Diseases, The First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China
| | - Wenbo Tan
- Department of Basic Medicine, School of Medicine, Shihezi University, Shihezi, China
| | - Ping Li
- Department of Nursing, School of Medicine, Shihezi University, Shihezi, China
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Shi C, Wang L, Lv D, Wang G, Mengist HM, Jin T, Wang B, Huang Y, Li Y, Xu Y. Epidemiological, Clinical and Laboratory Characteristics of Patients with Brucella Infection in Anhui Province, China. Infect Drug Resist 2021; 14:2741-2752. [PMID: 34295167 PMCID: PMC8291626 DOI: 10.2147/idr.s319595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background Brucellosis is currently one of the most widespread zoonotic diseases caused by Brucella genus, and the Brucella melitensis is the major pathogen. The number of people infected with Brucella has gradually increased in Anhui Province. Purpose To retrospectively evaluate the epidemiological, clinical, and laboratory data of brucellosis patients in Anhui Province. Patients and Methods A total of 109 brucellosis patients were admitted to the First Affiliated Hospital of Anhui Medical University from January 2012 to March 2021. Data from all patients were retrieved from the hospital’s electronic medical system. The final results were grouped and compared according to the presence or absence of bacteremic brucellosis and three phases of brucellosis. Results The most common symptoms among all 109 brucellosis patients were fever (89.0%), followed by chills (52.3%), arthralgia (48.6%), and weight loss (30.3%), and laboratory results presented with anemia (65.1%), elevate of C-reactive protein (CRP) (91.7%), erythrocyte sedimentation rate (ESR) (86.2%), aspartate aminotransferase (AST) (40.4%), and lactate dehydrogenase (LDH) (43.1%). The percentage of fever (96.1%), arthralgia (58.8%), anorexia (35.3%), leukopenia (31.4%), and the AST (51.0%) were higher in bacteremic than nonbacteremic group. Additionally, the median level of LDH (332.0 mg/L, IQR, 209.0–553.0) was higher in bacteremic than nonbacteremic group. Nevertheless, the albumin (36.0 mg/L, IQR, 33.9–38.2) was lower in the bacteremic group. The percentage of fever (94.9%) and the median LDH level (316.0 U/L (IQR,218.0–517.5)) in the acute phase of brucellosis were higher than the percentage of fever (72.0%) and the median LDH level (209.0 U/L (IQR,162.0–276.0)) in the subacute phase of brucellosis. Conclusion Brucellosis has become an important public health issue in Anhui Province. Brucellosis is a disease with diverse clinical manifestations. Our data showed that unexplained fever, arthralgia, and elevated AST and LDH should be considered as a diagnosis of bacteremia brucellosis for early treatment intervention.
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Affiliation(s)
- Cuixiao Shi
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Lianzi Wang
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Dongmei Lv
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Gang Wang
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Hylemariam Mihiretie Mengist
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230027, People's Republic of China
| | - Tengchuan Jin
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230027, People's Republic of China
| | - Bo Wang
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Ying Huang
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Yajuan Li
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Yuanhong Xu
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China
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