布鲁杆菌病38例流行病情况与临床特征分析

Epidemiologic analysis and clinical manifestations of 38 children with brucellosis

目的回顾性分析布鲁杆菌病在儿童患者中的流行病学特点、临床特征和治疗方法,提高儿科医生对此病的认识,为临床诊治提供依据。方法收集西安市儿童医院2015年7月至2018年7月在感染科住院的38例布鲁杆菌病患儿的病历资料进行回顾性分析。结果病例感染途径主要为接触传播(接触羊、牛,食用羊奶等),临床表现主要有发热、多汗、关节疼痛、活动障碍、咳嗽、皮疹、头痛、呕吐、肝大、脾大等,实验室检查主要表现为布氏杆菌凝集试验均阳性,血培养均培养出布鲁氏菌,肝功能损害、白细胞计数在正常范围内或稍偏低,淋巴细胞相对或绝对增多,降钙素原增高,部分病例可见贫血,治疗方法主要为第3代头孢类药物、复方新诺明(磺胺类)及利福平联合治疗,36例血培养阳性患儿6周疗程结束后复查血培养均转阴。结论布鲁杆菌病患儿一般有接触史,临床表现复杂多样,通过早期确诊和及时规范化治疗,可有效缓解患儿症状。

Objective To retrospectively analyze the epidemiological features, clinical manifestations and treatment of brucellosis in children with brucellosis so as to improve pediatrician’s knowledge about the disease and provide evidence for clinical management. Methods A retrospective analysis was conducted on data of 38 cases of brucellosis collected in Xi’an Children’s Hospital during July 2015 to July 2018. Results The commonest route of infection was contact(with goat, cow, and goat milk, etc), and most clinical manifestations were fever, sweating, arthralgia, impaired mobility, cough, rash, headache, vomit, enlarged liver and spleen. Lab data showed brucella agglutinant test (+), and brucella in blood, impaired liver function, normal or slightly reduced white blood count, relatively or absolutely increased lymphocytes, elevated procalcitonin, and anemia in some cases. The main treatments included the third generation cephalosporin, SMZ-TMP(sulfamides) plus rifampicin. Follow-up blood culture turned negative after 6 weeks medication. Conclusion Children with brucellosis associate with history of contacting with contagium and various clinical manifestations. Timely diagnosis and proper treatment can alleviate the disease effectively.