ABSTRACT
OBJECTIVES: To examine the epidemiology, clinical and hematological characteristics, complications and treatment outcome of childhood brucellosis in central Greece. METHODS: Retrospective record review of all patients 0-14 years of age with brucellosis admitted during a 16-year period between 1984 and 1999. RESULTS: A total of 39 cases (23 males, median age 132 months) were recorded in which the diagnosis was confirmed by a positive culture (n=30) or detection of IgM antibodies with ELISA (n=9). About 38% of these patients came from families of farmers or shepherds who owned a few domestic animals or small herds of goats or sheep and another 43% had consumed dairy products bought from shepherds. In 41% of the cases another family member developed symptomatic infection. Most of the patients presented with fever (61%) and musculoskeletal symptoms (69%). Splenomegaly was recorded in 38% and hepatomegaly in 28% of the cases. Anemia (39%) and monocytosis (31%) were the most common hematological manifestations, followed by lymphopenia (18%). Unusual complications were detected in two patients who developed thrombocytopenic purpura and acute facial nerve palsy, respectively, but recovered without long-term sequelae. None of the 22 patients who received a combination of two or three antibiotics for > or =6 weeks and had adequate follow-up had a relapse. CONCLUSION: Childhood brucellosis remains an important public health problem in central Greece. It usually occurs in families that raise small ruminants and the development of symptomatic infection in more than one family member is common. It may cause serious complications in children and treatment with at least two antibiotics for not less than six weeks appears to be effective.
Subject(s)
Brucellosis/complications , Brucellosis/therapy , Adolescent , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Antibodies, Bacterial/analysis , Brucella/immunology , Brucella/isolation & purification , Brucellosis/diagnosis , Brucellosis/epidemiology , Child , Child, Preschool , Female , Greece/epidemiology , Humans , Immunoglobulin M/analysis , Infant , Infant, Newborn , Male , Recurrence , Retrospective Studies , Risk Factors , Treatment OutcomeABSTRACT
UNLABELLED: The relationship between reactive thrombocytosis and the level of urinary tract infections was studied in 48 children. Platelets were counted before, during and after treatment. Reactive thrombocytosis was noticed in 74% of children with upper and in 14% with lower urinary tract infections. A significant rise in the platelet count presented in another five children (15%) with upper urinary tract infections. CONCLUSION: Reactive thrombocytosis was found almost exclusively in the renal parenchymal infections, usually during the recovery phase.
Subject(s)
Thrombocytosis/etiology , Urinary Tract Infections/complications , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Prospective StudiesABSTRACT
A case of polychondritis in a psoriatic boy is reported, involving purpura, arthritis which included the costochondral joints, and swelling of his scrotum, eyelids and pinnae. Many of his clinical manifestations showed an overlapping presentation with Schönlein-Henoch purpura (SHP).
