Epidemiological and clinical characteristics of 121 patients with acute brucellosis

Abstract

Objective To analyze the epidemiology and clinical features of patients with brucellosis in Xinjiang, in order to improve the understanding and diagnosis of brucellosis and we achieve early prevention.

Methods Prospective study design was used, 121 patients and inpatients in First Affiliated Hospital ,School of Medicine, Shihezi University from October 2015 to October 2019 were selected, and the epidemiological characteristics, clinical manifestations, treatment and outcomes of the selected cases were collected.

Results Among the 121 patients diagnosed with acute brucellosis, 92 were male (76.03%) and 29 were female (23.97%). The ratio of male to female was 3.14∶1.00, which the male incidence was higher. The average age of the selected cases was (44.52±11.78) years old, and the onset time was mainly from April to June. The main occupations of the selected patients were farmers, followed by cattle and sheep farmers. There were 79 cases (65.29%) of contact with cattle and sheep. Among the 121 patients who were enrolled, 105 (86.78%) had fever, the shortest fever time was 7 days, and the longest fever time was intermittent fever for more than 3 months. The fever was obvious in the afternoon and night. The low- fever body temperature was 37.3 -<38.0 ℃ in 24 cases (19.83%), the moderate-fever temperature was 38.0 -<39.0 ℃ in 52 cases (42.98%), and the body temperature ≥39 ℃ in 29 cases (23.97%), and there were 16 cases with no fever (13.22%). Some patients had symptoms such as chills, fatigue, muscle and joint pain, and sweating. Among the selected patients, WBC was normal in 73 cases (60.33%), WBC increased in 30 cases (24.79%), WBC decreased in 18 cases (14.88%), hsPCR increased in 82 cases (67.77%), PCT increased in 63 cases (52.07%), ALT increased in 51 cases (42.15%), AST increased in 47 cases (38.84%), AKP increased in 38 cases (31.04%), γ - GT increased in 45 cases (37.19%), Hb decreased in 13 cases (10.74%), PLT decreased in 16 cases (13.22%), ESR increased in 83 cases (68.60%). The main complications of brucellosis were osteoarthritis in 41 cases (33.88%), orchitis or epididymitis in 6 cases (4.96%), central nervous system in 5 cases (4.13%), endocarditis or pericarditis in 3 cases (2.48%). 121 patients were cured after active medical treatment, and there was no recurrence during follow-up.

Conclusions Among the patients with acute brucellosis, there are more males than females. The main onset population is farmers who have direct contact with cattle and sheep, and the main symptom is fever. The prognosis is better with standard treatment.

Abstract

摘要： 目的 分析新疆布鲁菌病患者流行病学及临床特点, 以提高诊断水平, 做到早期预防。 方法 选择 2015 年 10 月—2019 年 10 月在石河子大学医学院第一附属医院门诊及住院布鲁菌病患者 121 例, 分析入选病例流行病学特征、 临床表现、治疗和转归情况。 结果 确诊为急性期布鲁菌病的 121 例患者中, 男性 92 例 (76.03%) , 女性 29 例 (23.97%) , 男、女性别比为 3.14∶1.00。病例平均年龄为 (44.52±11.78) 岁, 发病时间主要在 4—6 月, 主要职业是农民, 其次是牛羊养 殖户, 明确与牛羊有接触者 79 例(65.29%)。发热时间最短为 7 d, 最长的间断发热 3 个多月, 以下午、夜间明显, 低热 37.3 ℃ ~ <38.0 ℃ 24 例 (19.83%), 中 度 热 38.0 ℃ ~ <39.0 ℃ 52 例 (42.98%), ≥39.0 ℃ 者 29 例 (23.97%), 无 发 热 者 16 例(13.22%)。部分患者出现畏寒、乏力、肌肉关节酸痛、多汗等症状。患者中 WBC 正常 73 例 (60.33%) , WBC 增多 30 例 (24.79%) , WBC 减少 18 例 (14.88%) , hsPCR 增高 82 例 (67.77%) , PCT 增高 63 例 (52.07%) , ALT 增高 51 例 (42.15%) , AST 增高 47 例 (38.84%) , AKP 增高 38 例 (31.04%) , γ-GT 增高 45 例 (37.19%) , HB 降低 13 例 (10.74%) , PLT 减少 16 例 (13.22%) , ESR 增高 83 例 (68.60%) 。主要并发症有骨关节炎 41 例 (33.88%) , 睾丸炎或附睾炎 6 例 (4.96%) , 中枢神经系统并发症 5 例 (4.13%) , 心内膜炎或心包炎 3 例 (2.48%) 。121 例患者经治疗后均治愈, 随访无复发。 结论 急性布病患者中, 男性多于女性, 发病人群主要是与牛羊有直接接触的农民, 主要症状是发热, 经过规范治疗后, 预后较好。