摘要
Objective:To identify characteristic features of tuberculosis in patients with culture proven brucellosis.Methods:A retrospective analysis was performed on patients diagnosed with culture proven brucellosis between January and December 2011,based on review of their medical records.Patients with demonstrable co-infection with tuberculosis were excluded.Clinical features,laboratory parameters and tissue histopathology reports where available were noted.Results:Thirty-two patients with brucellosis were included in the study.Twenty-one(65.63%)patients had chronic fever,thirteen(40.63%)had a productive cough,while significant weight loss,evening rise of temperature and night sweats were reported by eight(25.00%),eleven(34.38%)and five(15.63%)patients respectively.Nine(28.13%)patients had at least three of these symptoms.Lymphadenopathy,hepatomegaly and splenomegaly were noted on examination in seven(21.88%),fifteen(46.88%)and twelve(37.50%)patients respectively.Eight(25.00%)patients had hepatosplenomegaly,of these only two had associated significant lymphadenopathy.Respiratory examination was normal in all patients.Elevated ESR greater than 50 mm/hr was seen in eight(25.00%),it was greater than 100 mm/hr in five(15.63%)patients.Hypergammaglobulinemia was seen in eight(25.00%)cases.Bone marrow biopsy showed non-caseating granulomas in three(9.38%)cases,lymph node biopsy showed granulomas in one case.Overall,three(9.38%)patients had known risk factors for tuberculosis,while six(18.75%)had risk factors for brucellosis.Conclusions:There is a clear overlap between brucellosis and tuberculosis both in terms of clinical presentation and laboratory parameters.It is essential to c-arefully rule out tuberculosis in all cases of suspected or proven brucellosis before initiating antimicrobial therapy,in order to forestall development of drug-resistant tuberculosis.
Objective:To identify characteristic features of tuberculosis in patients with culture proven brucellosis.Methods:A retrospective analysis was performed on patients diagnosed with culture proven brucellosis between January and December 2011,based on review of their medical records.Patients with demonstrable co-infection with tuberculosis were excluded.Clinical features,laboratory parameters and tissue histopathology reports where available were noted.Results:Thirty-two patients with brucellosis were included in the study.Twenty-one(65.63%)patients had chronic fever,thirteen(40.63%)had a productive cough,while significant weight loss,evening rise of temperature and night sweats were reported by eight(25.00%),eleven(34.38%)and five(15.63%)patients respectively.Nine(28.13%)patients had at least three of these symptoms.Lymphadenopathy,hepatomegaly and splenomegaly were noted on examination in seven(21.88%),fifteen(46.88%)and twelve(37.50%)patients respectively.Eight(25.00%)patients had hepatosplenomegaly,of these only two had associated significant lymphadenopathy.Respiratory examination was normal in all patients.Elevated ESR greater than 50 mm/hr was seen in eight(25.00%),it was greater than 100 mm/hr in five(15.63%)patients.Hypergammaglobulinemia was seen in eight(25.00%)cases.Bone marrow biopsy showed non-caseating granulomas in three(9.38%)cases,lymph node biopsy showed granulomas in one case.Overall,three(9.38%)patients had known risk factors for tuberculosis,while six(18.75%)had risk factors for brucellosis.Conclusions:There is a clear overlap between brucellosis and tuberculosis both in terms of clinical presentation and laboratory parameters.It is essential to c-arefully rule out tuberculosis in all cases of suspected or proven brucellosis before initiating antimicrobial therapy,in order to forestall development of drug-resistant tuberculosis.
