ABSTRACT
Objective:To analyze the clinical data of adult patients with brucellosis and provide scientific basis for treatment of brucellosis.Methods:The medical records of 1 279 adult brucellosis patients treated in the Brucellosis Department of Hulunbuir People's Hospital from January 2013 to December 2020 were selected. Epidemiological characteristics, clinical characteristics, laboratory examination, complications and curative effect were analyzed retrospectively.Results:Among the 1 279 cases of brucellosis, there were 797 males and 482 females, with an average age of (39 ± 15) years. There were 464 cases in acute stage, 815 cases in chronic stage, and 1 221 cases contacted with animal fur such as cattle, sheep and sheep skin. The main clinical manifestations were fatigue (974), fever (819), hyperhidrosis (674) and joint and muscle pain (752). Spleen enlargement was the most common sign, with 151 cases in sequence. There were 623 complications in 1 279 patients with brucellosis. Bone and joint damage, blood system damage and liver damage were more common, with 563, 298 and 264 cases, respectively. Some patients even had multiple system damage. The titer range of in vitro agglutination test (SAT) in 1 279 patients with brucellosis was 1 ∶ 50++ to 1 ∶ 1 600++; 198 cases were positive for Brucella in blood culture; SAT was positive in 8 cases of cerebrospinal fluid and 4 cases of pleural effusion. There were 114 cases of leucopenia, 51 cases of leucopenia, 158 cases of thrombocytopenia, 93 cases of decreased hemoglobin, 205 cases of elevated alanine aminotransferase, 198 cases of elevated aspartate aminotransferase and 143 cases of elevated creatinine in 1 279 patients with brucellosis. Erythrocyte sedimentation rate increased in 587 cases and C-reactive protein increased in 563 cases. After treatment with two or three antibiotics for at least 12 weeks, the total effective rate was 98.3% (1 257/1 279). Conclusions:The clinical manifestations of brucellosis are varied. Clinicians should highly suspect brucellosis if the patient has a history of epidemiological exposure to brucellosis and has symptoms such as fever, sweating, joint muscle pain and fatigue. Early diagnosis and standardized treatment should be carried out to prevent the disease from becoming chronic and affecting the quality of life. The occupational population should strengthen physical examination and education for brucellosis.
ABSTRACT
Objective:To understand the clinical characteristics of Brucella epididym-orchitis (BEO). Methods:The clinical data of married male patients with brucellosis in acute stage admitted to Hulunbuir People's Hospital from September 2017 to October 2019 were collected and divided into BEO group and non-BEO group, with 46 and 50 cases, respectively. The clinical manifestations, laboratory examination and treatment effect were analyzed and evaluated.Results:The frequency of lower abdominal pain, erectile dysfunction and premature ejaculation in BEO group were higher than those in non-BEO group [26.1% (12/46) vs 8.0% (4/50), 89.1% (41/46) vs 12.0% (6/50), and 28.3% (13/46) vs 6.0% (3/50), χ 2 = 5.643, 57.037, 8.548, P < 0.05]. In laboratory examination, the incidence of increased leukocyte (WBC) count in BEO group was significantly higher than that in non-BEO group [23.9% (11/46) vs 8.0% (4/50), χ 2 = 4.602, P < 0.05]. In terms of sperm function, the incidence of decreased sperm dens (DENS) in BEO group was significantly higher than that in non-BEO group [21.7% (10/46) vs 2.0% (1/50), χ 2 = 9.201, P < 0.05]. After 2 - 7 d of treatment, the pain and/or tenderness of scrotum were relieved in all patients with BEO. After 3 - 5 d of treatment, the symptoms of BEO patients with lower abdominal pain and dysuria were relieved. After 12 weeks of treatment, 97.8% (45/46) of BEO patients had normal scrotal and testicular ultrasonography; 95.1% (39/41) of BEO patients had normal erectile function, 76.9% (10/13) of BEO patients had no premature ejaculation, and DENS returned to normal in 80.0% (8/10) of patients with DENS decreased. Five cases' sperm motility (PRNPPER) returned to normal of 6 patients with PRNPPER decreased. Conclusion:BEO patients have the clinical characteristics of lower abdominal pain, erectile dysfunction, premature ejaculation and spermatogenic dysfunction, and the overall prognosis is good after treatment.
ABSTRACT
Objective:To understand the prevention knowledge of brucellosis among permanent residents in the agricultural area of Hulunbuir City, Inner Mongolia Autonomous Region, and to provide a scientific basis for formulating brucellosis prevention strategies and measures.Methods:From May to December 2018, Daur Autonomous Banner of Morin Dawa and Arun Banner in the agricultural area of Hulunbuir City were selected as the survey sites. Three townships were selected from each banner, and one administrative village from each township was selected as the survey village. The permanent residents aged ≥14 who had lived in the survey village for at least one year were selected as the survey subjects. Serum was separated by the examiner and the rose-bengal plate agglutination test (RBPT) was conducted. The positive sera were further tested by tube agglutination test (SAT).Questionnaires were conducted by investigators in the form of face-to-face case interview, including general demographic information, family information, brucellosis prevention knowledge awareness status, epidemiological contact history, prevention status, general behavior, etc., to calculate the awareness rate of brucellosis prevention knowledge.Results:A total of 880 sera were isolated, of which 185 were positive for RBPT. Further examination of SAT showed that the positive rate of SAT was 17.27% (152/880). The overall awareness rate of brucellosis prevention knowledge was 46.73% (16 450/35 200). The awareness rates of males and females were 47.82% (8 473/17 720) and 45.64% (7 977/17 480), respectively. The 21 - 40 years old group had the highest awareness rate [60.94% (3 705/6 080)]. The awareness rates of primary school and below, junior high school, senior high school and above were 45.96% (11 969/26 040), 48.79% (3 962/8 120) and 49.90% (519/1 040), respectively. The awareness rate of people with livestock raising behavior in the year before the survey was 47.35% (8 011/16 920), while the awareness rate of people without such behavior was 46.17% (8 439/18 280).Conclusions:The overall awareness rate of brucellosis prevention knowledge among permanent residents in the agricultural area of Hulunbuir City is low. It is necessary to strengthen the training of relevant knowledge and strengthen the publicity and education of people with low awareness rate.
ABSTRACT
Objective:To investigate the clinical characteristics of patients infected with Brucella Melitensis ( B. Melitensis) type 1 and type 3 in Hulunbuir, Inner Mongolia Autonomous Region. Methods:A retrospective analysis method was used to collect clinical medical records of patients with brucellosis admitted to Hulunbuir People's Hospital from June 2013 to August 2017, and 71 patients with brucellosis positive in blood culture and identified by polymerase chain reaction (PCR) and AMOS-PCR were selected as the study subjects. According to the identification results, they were divided into B. Melitensis type 1 and type 3 groups. General information, epidemiological characteristics, clinical characteristics, laboratory examinations, complications and efficacy of the two groups were compared. Results:Among 71 patients with brucellosis, 22 cases were B. Melitensis type 1, including 16 males and 6 females, aged (39.91 ± 16.04) years old; 49 cases were B. Melitensis type 3, including 34 males and 15 females, aged (40.67 ± 18.72) years old. There were no significant differences in gender composition and age between the two groups (χ 2 = 0.081, t = 0.166, P > 0.05). There were 10 cases(45.5%) of B. Melitensis type 1 patients living in agricultural areas, 10 cases (45.5%) in pastoral areas, and 2 cases (9.1%) in cities; there were 40 cases (81.6%) of B. Melitensis type 3 patients living in agricultural areas, 7 cases (14.3%) in pastoral areas and 2 cases (4.1%) in cities, and the difference between regions was statistically significant (χ 2 = 9.276, P < 0.05). Testicular swelling and pain symptoms [22.7% (5/22), 6.1% (3/49)] in B. Melitensis type 1 and type 3 patients were compared, the difference was statistically significant (χ 2 = 4.187, P < 0.05); other clinical features were compared, the differences were not statistically significant ( P > 0.05). There were no significant differences in white blood cell count (WBC) and platelet count (PLT) decreased, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased between the two groups ( P > 0.05). The number of complications in B. Melitensis type 1 and type 3 patients were 12 cases (54.5%) and 14 cases (28.6%), respectively, and the difference between the two groups was statistically significant (χ 2 = 4.413, P < 0.05). Ten cases (45.5%) of B. Melitensis type 1 patients were cured, 12 cases (54.5%) were improved, 34 cases (69.4%) of B. Melitensis type 3 patients were cured, 15 cases (30.6%) were improved, and there were no invalid or relapsed patients in both groups, the difference in curative effect between the two groups was statistically significant (χ 2 = 3.690, P < 0.05). Conclusions:In Hulunbuir, Inner Mongolia Autonomous Region, there are differences in the living areas of B. Melitensis type 1 and type 3 patients. The B. Melitensis type 1 patients are prone to testicular swelling and pain and brucellosis complications.
ABSTRACT
Objective:To analyze the epidemiological characteristics, clinical features of brucellosis patients with abnormal blood routine, and to improve the awareness of brucellosis among clinicians.Methods:A total of 1 036 patients with brucellosis admitted to the Department of Brucellosis, Hulunbuir People's Hospital from January 2011 to December 2017 were selected, including 274 patients with abnormal blood routine (case group), and 762 patients with normal blood routine(conrtol group). Epidemiological characteristics, clinical features and laboratory tests were analyzed retrospectively.Results:In 274 patients of case group, there were 128 males and 146 females, and the age was (36.3 ± 18.7) years old. In 762 patients of conrtol group, there were 381 males and 381 females, and the age was (35.4 ± 20.4) years old, and there were no significant differences in sex ratio and age between the two groups ( P > 0.05). The main route of infection in the two groups was to raise livestock such as sheep and cattle, 254 cases (92.7%) and 724 cases (95.0%), respectively. The proportions of patients with dizziness symptoms were 31.0% (85/274) and 17.7% (135/762) in the two groups, and the proportions of patients with rash were 14.2% (39/274) and 3.0% (23/762), and the differences were statistically significant between the two groups (χ 2 = 21.331, 45.054, P < 0.05). The symptoms of fever, sweating and fatigue were common in both groups, and the splenomegaly was the most common sign. However, there were no significant differences in the proportion of abnormal characteristics between the two groups ( P > 0.05). Among the 274 patients in case group, 48 had leucopenia, 160 had anemia, and 148 had thrombocytopenia; and 17 had both leucopenia and anemia, 23 had both leucopenia and thrombocytopenia, and 16 had both anemia and thrombocytopenia, and 13 had leucopenia, anemia, and thrombocytopenia at the same time. Conclusions:In the brucellosis epidemic area, when the patient has symptoms such as fever, fatigue, sweating, leucopenia, anemia, and thrombocytopenia, and excluding abnormal blood routine caused by other reasons, clinicians should consider the possibility of Brucella infection.
ABSTRACT
Objective:To understand the characteristics of brucellosis in key population in rural areas of Hulunbuir City, Inner Mongolia Autonomous Region, and clarify the influencing factors of brucellosis infection, such as knowledge, belief and behavior, so as to provide scientific basis for the formulation of brucellosis prevention strategies and measures.Methods:A case-control study was used to study the confirmed cases of brucellosis among the key population of brucellosis in Hulunbuir rural areas in 2018. The patients without brucellosis were selected as control group. A questionnaire survey was used to investigated brucellosis related knowledge. The health-related behaviors (including raising livestock, cleaning houses, wells shared by human and livestock, immunizing livestock) were analyzed by single factor variation analysis and logistic regression analysis.Results:This study investigated 892 cases of population, 881 people responded effectively to the questionnaire, including 445 males, accounting for 50.51%, 436 females, accounting for 49.49%; the age range of 5-83 years old, the average age of (51.34 ± 11.87) years old; 153 cases of brucellosis antibody positive. The infection rate of brucellosis in this area was 17.37%, in which the male infection rate was 22.47%(100/445), and the female infection rate was 12.16% (53/436). There was a significant difference between male and female(χ 2=16.331, P < 0.05). Logistic regression analysis showed that raising cattle, cleaning houses, wells shared by human and livestock, using manure from cattle and sheep to fertilize, immunizing livestock were risk factors of brucellosis infection ( OR=1.905, 1.568, 1.320, 1.428, 1.488, P < 0.05). Conclusions:The incidence rate of brucellosis in Hulunbuir is higher than that in females. Close contact with infectious livestock and their excreta is a risk factor for brucellosis infection. According to the results of this survey. It is necessary to strengthen health education and behavior intervention of key population in order to effectively prevent and control brucellosis.
ABSTRACT
Brucellosis is a zoonotic,acute and chronic systemic disease caused by Brucella,the incidence is increasing year by year.Brucella can invade many organs and tissues of human body,affect working ability,and even cause disability and death,seriously endanger human health.Now the main treatment method of brucellosis is multi-course and combined application of antibacterial drugs,but long-term using of such drugs is prone to drug resistance and adverse reactions.In recent years,the combination of traditional Chinese and western medicine has been applied to treat brucellosis and achieved certain curative effect.In this paper,the current situation in treating brucellosis by integrated traditional Chinese and western medicine is summarized and prospected.
ABSTRACT
Objective To analyze the epidemiological and clinical characteristics of patients with acute brucellosis for providing theoretical basis for its clinical diagnosis and treatment in Hulunbuir of Inner Mongolia.Methods The epidemiology,clinical features,laboratory examination and therapeutic effect of acute brucellosis patients admitted to Department of Brucellosis of Hulunbuir People's Hospital from January 2013 to December 2017 were retrospectively evaluated.Results Totally there were 197 patients with acute brucellosis were collected,139 males and 58 females aged from 19 to 71 years old (average age 39.2).There were 179 cases with a clear history of epidemiology,and 168 cases had directly contacted with animals,39 cases had family history of brucellosis.The dominant manifestations were fever in 181 cases (91.9％),sweats in 159 cases (80.7％),and the dominant sign was splenomegaly in 28 cases (14.2％).There were 123 cases (62.4％) with complications,most patients with osteoarticular involvement and liver damage,43 and 59 cases (21.8％ and 29.9％) respectively.Both the Rose Bengal Plate Agglutination Test (RBPT) and Standard Tube Agglutination Test (SAT) were positive in 197 patients,the blood culture was positive in only 37 cases.Cerebrospinal fluid SAT positive was in 8 cases,and pleural effusion SAT in 2 cases;cerebrospinal fluid and pleural effusion culture were negative.Of the 197 patients,185 patients had a good effect after treatment,and the treatment effective rate was 93.9％.Conclusions Acute brucellosis is an infection with multiple presentations,the presence of persistent fever,sweats,muscular soreness and arthralgia should alert clinicians the possibility of acute brucellosis.Early diagnosis and treatment will reduce the incidence of complications.
ABSTRACT
Objective@#To analyse epidemiological, clinical characteristics and laboratory examination results of 245 occupational brucellosis form 2008 to 2018, which providing theoretical basis for prevention and control of occupational brucellosis.@*Methods@#Based on the China Center for Disease Control and Prevention Information System, a database of occupational brucellosis cases in HunlunBuir from January 2008 to July 2018 was established. The Epidemiological characteristics, Clinical manifestation, laboratory examination of 245 occupational brucellosis and 359 without occupational brucellosis were comparatively analyzed about the same period.@*Results@#Among the 245 patients, 219 were males, 254 in 359, malese were significantly higher than control group (χ2=21.331, P<0.05) . Fever, fatigue, hyperhidrosis and splenomegaly are common in patients with occupational brucellosis and non occupational brucellosis. Arthralgia (54.3%/44.8%) and CRP (81.2%/71.3%) were significantly also higher than control group (χ2=5.193, P<0.05; χ2=7.704, P<0.05) Fever, hyperhidrosis, fatigue and splenomegaly were common clinical manifestation and signs in the two groups. Brucellosis can cause a variety of complications, including osteoarticular hematological system and hepatic involvement, some patients with multiple system damage.@*Conclusion@#The incidence of occupational brucellosis in HulunBuir is concentrated in agriculture and animal husbandry. Veterinarians are the main occupational groups, Occupational health interventions should be strengthened for key occupational hazards, regular occupational health examination, avoid chronic brucellosis and protect the health of key occupational groups.
ABSTRACT
Objective To explore the clinical and laboratory characteristics of patients with brucellosis spondylitis (BS),and to provide theoretical basis for its clinical diagnosis and treatment.Methods The data of brucellosis patients treated in the Department of Brucellosis,Hulunbuir People's Hospital from January 2011 to December 2016 were analyzed retrospectively in this study.Results A total of 869 cases of brucellosis were investigated,including 73 cases of BS.The incidence of back pain was 90.4％ (66/73) and 20.4％ (162/796) in BS patients and those without spondylitis,the difference was statistically significant (x2 =169.587,P ＜ 0.05).Magnetic resonance imaging (MRI) revealed the sites of involvement were lumbar (63),thoracic (6),cervical (4),thoracolumbar (3),paravertebral abscess (22),and epidural abscess (12).Multiple segments involvement of lumbar spine was most common.Three patients showed jumping damage to their spines,one of them showed simultaneous cervical and lumbar injuries,and two cases presented simultaneous thoracic and lumbar injuries.After combined application of at least two antimicrobial agents for 24 weeks,28 cases were cured,42 cases were improved and 3 cases were ineffective.The total effective rate was 95.9％ (70/73).Conclusions In brucellosis endemic areas such as Hulunbuir,BS should be considered in patients with back pain and fever.MRI is a highly sensitive imaging modality that can be used to differentiate BS from other spinal infections.
ABSTRACT
Objective To analyze the epidemiological characteristics,clinical manifestations and laboratory examinations of occupational brucellosis (OB) in Hulun Buir City,Inner Mongolia,from 2008 to 2016,in order to provide experience for prevention and treatment of OB.Methods The data of human OB cases from 2008 to 2016 in Hulun Buir were extracted from the Chinese Information System for Diseases Control and Prevention (CISDCP).The available information included population distribution,geographical distribution,time distribution,occupational distribution,clinical manifestations and laboratory examinations of the cases.Results Of the 213 cases,191 were males and 22 females,aged from 23 to 62 years old,149 cases in their 25-44 years of ages among all age-gender groups,and 20.19％ of the cases (43) were reported in Ergun.Though occurred yearly and monthly,the disease reached the peaks in 2013 (41 cases),and in January (70 cases).A total of 212 cases had directly contacted with animals,only one was medical staff,116 were veterinary.The dominant manifestations were arthralgia and myalgia in 144 cases,sweats in 131,fatigue in 123,fever in 94 cases,splenomegaly in 17 cases,hepatomegaly in 4 cases,and hepatosplenomegaly in 2 cases.The positive rate of the Bengal plate agglutination test (RBPT) was 100％,standard tube agglutination test (SAT) title ≥ 1 ∶ 100 (++) in 195,and SAT title ≥ 1 ∶ 50 (++) in 18 cases.Abnormal laboratory findings included elevated C-reactive protein (CRP),aspartate transaminase (AST),and alanine aminotransferase (ALT) levels in 34,42 and 84 cases.Conclusions Occupational brucellosis is male-dominated,and concentrated in veterinary services.For exposed population,relevant departments should strengthen occupational health education,periodic occupational health examination.
ABSTRACT
Objective To analyze clinical and laboratory results of 38 children with brucellosis for providing theoretical basis for its clinical diagnosis and treatment. Methods The epidemiology, clinical features, laboratory characteristics and therapeutic effect of pediatric patients at HulunBuir People's Hospital from January 2011 to December 2015, were retrospectively evaluated. Results Totally there were 38 child patients with brucellosis, 24 males and 14 females, 36 children had directly contacted with animals, and onset seasons were mainly in Summer and Autumn. The dominant manifestations were fever in 33 (86.8%), anorexia in 21 (55.3%), arthralgiaand myalgia in 17 (44.7%), hepatomegaly in 5 (13.2%), splenomegaly in 11 (28.9%), and lymph nodes enlargement in 10 (26.3%). Abnormal laboratory findings included elevated C-reactive protein (CRP) level in 27 (71.1%) and erythrocyte sedimentation rates (ESR) in 24 (63.2%). Both the Rose Bengal test and serum agglutination test (SAT) were positive in 37 patients, only one patient was negative but the blood culture was positive. After at least 12 weeks of combined, adequate and standardized treatment, there were 30 pediatric brucellosis patients cured, improved in 8 cases, the total effective rate was 100.0%. Conclusions In endemic regions, the presence of persistent fever, joint pain and hepatosplenomegaly should alert clinicians the possibility of brucellosis. Early diagnosis and treatment will reduce the incidence of complications.
ABSTRACT
Objective Study the epidemiological and clinical findings of patients with Brucellar epididymo-orchitis (BEO),to provide a theoretical basis for clinical diagnosis.Methods A study was carried out to analyze the patients' files of epidemiological,outcome,clinical and laboratory features of 23 cases of BEO and 185 in patients with brucellosis in Hulunbuir People's Hospital during 2011-2013.Results The age of patients with BEO and without epididymo-orchitis (EO) were (34.48 ± 10.32) years old and (42.07 ± 12.19) years old,the difference was statistically significant (t =-2.842,P ＜ 0.05).Patients with BEO and without EO of brucellosis patients with hypogastralgia ratio was 78.3％ (18/23) and 8.6％ (14/162),the difference was statistically significant (x2 =68.238,P ＜ 0.05).The proportion of BEO cases with abnormal White Blood of Cell (WBC) and C-reactive protein (CRP) levels were 34.8％ (8/23) and 91.3％ (21/23),which was significantly higher than those in without EO group [9.9％ (16/162),63.0％ (102/162),x2 =11.066,7.260,all P ＜ 0.05].After 2 to 7 days,BEO patients with scrotal swelling and pain and/or tenderness relieved.After two weeks treatment,11 patients of the urinary system showed normal by ultrasound,and no patients underwent testicular resection.Conclusions Young male patients with Brucellar are prone to BEO.Laboratory abnormalities are mainly leukocytosis and high CRP level.
ABSTRACT
Objective To investigate the clinical treatment of brucellosis spondylitis (BS) through combination of Mongolian medicine and Western medicine.Methods From December 2010 to June 2015,51 patients which were diagnosed BS at the Department of Brucellosis Hulunbuir People's Hospital were enrolled in this study.After injecting etimicin sulfate and levofloxacin for two weeks,rifampin and doxycycline were administrated orally with Silver pearl pill,Pearl pill and Yunxiang pill (tid) for one treatment cycle which contained three courses of each treatment for 3 weeks.Before and after the treatment,the clinical features and imaging examination results were observed of 2 cases and then followed up for one year.Results Before the treatment,any spinal segment can be affected especially the lumbar spine.Two cases of cervical damage,5 cases of thoracic vertebrae,47 cases of lumbar spine,2 cases of sacral vertebrae,and 39 cases of vertebral abscess were found.After treatment,low back pain symptoms disappeared in 10 cases of the patients.Thirty-nine patients with low back pain symptoms and limited movement.Two patients with low back pain aggravated,MRI examination of the lumbar spine showed lesions increased and abscess formation.The effective rate of Mongolian herbal medicine and Western medicine treatment was 96.1％ (49/51).Conclusion The combined treatment of BS through combination of Mongolia medicine and Western medicine is effective.