布鲁氏菌病的实验室特征与临床分析

A Clinical and Laboratory Analysis of Brucellosis in Yunnan Province

目的分析总结云南省布鲁菌病的流行病学、实验室检查及临床特点,以提高对布鲁菌病的认识和诊治水平.方法回顾性分析2013年1月至2014年12月收治的8例布鲁菌病患者临床资料及复习相关文献.结果 8例患者均有明确的流行病学史,均有发热、肝脾及淋巴结肿大、乏力、出汗.就诊于泌尿外科、呼吸科、内分泌科、感染科、肿瘤科、血液科、神经内科等不同临床科室,1例以发热、全身肌肉酸痛为主;1例反复不明原因发热;1例发热伴白细胞、血小板减少原因待查;1例右腰腹部疼痛;1例右下腹持续性隐痛;1例发热、咳嗽、咳痰;1例间断头痛;1例无明显诱因出现左侧睾丸肿痛.8例血培养均阳性,经细菌学鉴定为布鲁氏菌.血液白细胞计数及肝功能多数正常.结论布鲁菌病临床表现多样,病人首诊于不同临床科室,对长期不明原因发热者临床和检验医师应结合流行病学特点警惕布鲁菌病,及时行体液细菌学检查,血培养是诊断布鲁氏菌病的有效手段.

Objective To improve our understanding of brucellosis by analyzing its epidemiological and clinical features, laboratory examination of brucellosis in Yunnan Province. Methods Clinical and laboratory data of brucellosis patients in Qujing First People＇s Hospital from 2013 to 2014 were retrospectively analyzed with its relevant literature reviewed. Results A clear epidemiological history was found in all the 8 brucellosis patients, and they were manifested as fever, sweat, weakness, hepatosplenomegaly and lymphadenopathy. They got to their first appointment in all kinds of clinical departments, such as Urology, Endocrinology, respiration, infectious diseases, ontology, Hematology, neurology and other clinical departments. Among the other accompanied various symptoms and signs of the patients included fever and muscle ache, fever of unknown origin, fever with white blood cells reduction, right abdominal pain, fever accompanied cough and sputum, discontinuity headache and no obvious inducement of left testis gall pill. Cultured venous blood from 8 patients was positive for brucella. Blood white blood cell count and liver function are normal. Conclusion Brucellosis shows various clinical manifestations, and the brucellosis patients are first diagnosed at different clinical departments. So, clinical and laboratory physicians should pay more attention to brucellosis combining with the epidemiological characteristics, as early as possible to perform the blood bacterial culture for patient with long-term fever due to unknown reasons.