24例布鲁氏杆菌病患儿临床特征及治疗

The clinical features and treatment of Brucellosis disease in 24 children

目的 了解近年儿童布鲁氏杆菌病的临床特征及治疗.方法 回顾分析2011年1月至2015年12月收治的24例布鲁氏杆菌病患儿的临床资料.结果 24例患儿, 男18例、 女6例, 平均年龄 （9.8 ± 3.13） 岁 （4-14岁）. 24例患儿虎红平板凝集试验反应均为阳性, 抗体滴度为1：800-1：100, 均确诊布鲁氏杆菌病. 患儿主要居住在农牧区; 4例 （16.67%） 有患病家属和牛、 羊接触史, 3例 （12.5%） 仅有患病家属接触史, 12例 （50.00%） 有牛、 羊接触史, 3例 （12.5%） 既往2年家中圈养牛、 羊, 2例 （8.33%） 传播途径不明确. 全年均有发病, 6月和7月发病率最多. 常见临床症状为发热、 关节疼痛、 乏力、盗汗、 厌食, 并有伴脾和肝肿大. 〈 8岁患儿采用利福平联合复方磺胺甲噁唑, ≥8岁患儿则采用多西环素联合利福平治疗.23 例经治疗后已痊愈, 仅1 例患儿出院服药3周后自行停药, 导致病情复发. 结论对不明原因反复发热的牧区患儿, 应注意排除布鲁氏杆菌病.

Objective To investigate the clinical features and treatment of Brucellosis disease in children in recent years. Methods The clinical data of 24 children with Brucellosis disease admitted during January 2011 to December 2015 were retrospectively analyzed. Results In 24 children, 18 was male and 6 was female and average age was 9.8±3.13 years （4-14 years）. Twenty-four children were diagnosed with Brucellosis disease by positive tiger red plate agglutination tests and their antibody titer was 1：800-1：100. The children lived mainly in the pastoral areas; four cases （16.67%） had sick family members and cattle and sheep; three cases （12.5%） had histoty of contact only with sick family members; 12 cases （50.00%） had cattle and sheep exposure history; 3 cases （12.5%） had raised cattle or sheep at home in the past 2 years; 2 cases （8.33%） had not have clear transmission route. The onset of the disease occurred year round, with the highest incidence in June and July. The common clinical symptoms were fever, arthralgia, weak, sweat, and anorexia, combined with hepatomegaly and splenomegaly. Patients younger than 8 years old were treated with rifampin and sulfamethoxazole. Patients equal to or older than 8 years old were treated with doxycycline and rifampin. Twenty-three children had been cured after treatment. Only one child stopped taking the drugs 3 weeks after discharge, which resulted in recurrence. Conclusion For children living in pasturing area suffered with unexplained recurrent fever, brucellosis disease should be considered and ruled out.