Clinical characteristics of 13 cases of brucellosis complicated with rash / 中华地方病学杂志

ABSTRACT

Objective:To analyze the clinical characteristics of brucellosis complicated with rash.Methods:The medical records of 13 patients diagnosed with brucellosis complicated with rash diagnosed at the Hulunbuir People's Hospital from January 2017 to January 2022 were collected. Patient general information, clinical characteristics, laboratory tests and treatment results were analyzed by retrospective investigation.Results:Among the 13 patients with brucellosis complicated with rash, 10 were females and 3 were males, the youngest age was 39 years, and the oldest age was 62 years. All patients had fever, which may be accompanied by symptoms such as chills, fatigue, hyperhidrosis, arthralgia, headache and other symptoms. Among the 13 patients, 12 had scattered red or dark red macules/papules/maculopapules on the trunk and limbs, and 1 had red macules on both lower limbs, ranging in size from 2 to 10 mm, with no itching or pain symptoms, and the rash did not fade under pressure. All patients tested positive for rose bengal plate agglutination test (RBT) and in vitro serum agglutination test (SAT). Brucella was isolated and cultured from blood samples of 4 patients. All patients showed elevated levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), with detection values ranging from 27.1 to 146.4 mg/L and 22 to 79 mm/hr, respectively. Platelet and hemoglobin decreased in 1 case, 64 × 10 9/L and 96 g/L, respectively. Seven patients showed elevated levels of alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST), with detection values ranging from 51 to 204 and 45 to 210 U/L, respectively. Creatinine increased in 2 patients, and the detection values ranged from 92.6 to 125.3 μmol/L. Three patients had abnormal urine routine; bone damage was found in 1 patient. After 12 weeks or more of combined, full dose and full course of drug treatment, 12 cases were cured and 1 case improved, with a treatment effectiveness rate of 100%. Conclusions:The incidence of brucellosis complicated with rash is low. When the patient has a history of epidemiological contact with brucellosis, and has symptoms of fever and rash, combined with laboratory test results, brucellosis can be considered, and early treatment could lead to a good prognosis.