Affiliations: Pediatric Infectious Research Center, Mofid Children
Hospital, Shaheed Beheshti University of Medical sciences, Tehran, Iran
Note: [] Correspondence: Dr. Babaie Delara, Pediatric Infectious Research
Center, Mofid children hospital, Shariati Street, Tehran, 15468-15514, Iran.
Tel.: +98 2122367984; Fax: +98 2122226941; E-mail: delara77@yahoo.com
Abstract: Brucellosis is a common infection of children in Iran. Considering
the prevalence of complications in children, early diagnosis and treatment are
crucial for prevention of morbidity and mortality. We retrospectively
(1996–2005) studied all children who were diagnosed with brucellosis in one of
the largest referral pediatric hospitals in Tehran, Iran. Inclusion criteria
were positive Wright test (⩾ 1/80 in Iranian population) and
2-mercaptoethanol (⩾ 1/20) or isolation of brucella in sterile body
fluids. Clinical manifestations, serologic, radiologic and other laboratory
findings were analyzed. Data were evaluated on medical reports of 54 children
with brucellosis during 1996–2005. The clinical manifestations varied: fever
in 40 patients (72%), arthralgia in 27 (50%), hepatosplenomegaly in 18
(32%) and gastrointestinal involvement in 17 (31%). One third of patients
had anemia and 25 of them (46%) had low mean corpuscular volume values.
Erythrocyte sedimentation rate was more than 20 in 34 (75%) of examined
patients. Wright was performed in all patients, 26 (48%) of whom had titers
equal or more than 1/320. Coombs Wright was 1/320 in 18 (33%), and
2-mercaptoethanol was positive in all patients (⩾ 1/20). Common antibiotic
regimens were co-trimoxazole plus rifampin, co-trimoxazole plus streptomycin
and co-trimoxazole plus rifampin and gentamicin. Brucellosis presents with
variable manifestations, so diagnosis may be difficult, resulting in~delay of
treatment. Therefore, early diagnosis and treatment by more effective
combinations will be useful for decreasing the rate of morbidity, mortality and
relapse.
