Scorpion envenomation in children: an analysis of 99 cases.

Scorpion envenomation is a life-threatening emergency and a common public health problem in many regions of the world, particularly in children. The aim of this retrospective descriptive study was to describe the epidemiological characteristics and some common clinical symptoms and signs, laboratory findings and outcomes among humans in the southeast Anatolia region of Turkey (Mardin, Midyat). The sting cases mostly occurred in the month of July (36.4%) when the annual temperature is the highest. The majority of the cases were in the 6-10 years of age group. Most of the stings were seen in exposed extremities (92.9%), mainly in the lower limbs (58.6%). Patients in the emergency units showed signs of local and systemic effects, but no lethality occurred except one. Local and autonomic nervous system effects were most frequently characterized by local pain, hyperemia, swelling, itching, malaise, dry mouth, sweating, and thirst. Neurological, cardiovascular and respiratory disorders were uncommon. The global mortality recorded was 10 per 1000 cases. In conclusion, we propose that this information is beneficial for health education and prevention of scorpion sting cases.

Pulmonary involvement in brucellosis.

BACKGROUND: Brucellosis is a zoonotic disease caused by a Gram-negative bacillus of the Brucella genus with multisystem involvement, primarily affecting the reticuloendothelial system, joints, heart and kidneys. Although the disease can be spread by inhalation, pulmonary involvement is rare. OBJECTIVE: To report a case of brucellosis with pulmonary involvement. CASE PRESENTAION: A previously healthy 36-year-old woman was admitted with complaints of fever, weakness, night sweats, dry cough and bilateral chest pain. She hed been diagnosed with pneumonia 20 days previously and was started on a course of ampicillin for 14 days, with no response. Her chest auscultation revealed diminished breath sounds and scattered crackles and rhonchi over the inferior zone of the right hemithorax. Wright and Coombs testing resulted in titres of 1:1280 and 1:640, respectively. Chest radiography revealed an area of confluent lobar consolidation in the right lower lobe. Treatment was started with a six-week course of oral doxycycline 200 mg/day and rifampicin 600 mg/day. This treatment regimen rapidly improved the patient's condition. Follow-up after one year showed no residual effects from the infection. CONCLUSION: Pulmonary involvement is a rare event in the course of brucellosis, but the rate could be higher than currently estimated. In endemic regions, brucellosis should be considered as a causative agent in patients with pulmonary symptoms. BACKGROUND: Brucellosis is a zoonotic disease caused by a Gram-negative bacillus of the Brucella genus with multisystem involvement, primarily affecting the reticuloendothelial system, joints, heart and kidneys. Although the disease can be spread by inhalation, pulmonary involvement is rare. OBJECTIVE: To report a case of brucellosis with pulmonary involvement. CASE PRESENTAION: A previously healthy 36-year-old woman was admitted with complaints of fever, weakness, night sweats, dry cough and bilateral chest pain. She hed been diagnosed with pneumonia 20 days previously and was started on a course of ampicillin for 14 days, with no response. Her chest auscultation revealed diminished breath sounds and scattered crackles and rhonchi over the inferior zone of the right hemithorax. Wright and Coombs testing resulted in titres of 1:1280 and 1:640, respectively. Chest radiography revealed an area of confluent lobar consolidation in the right lower lobe. Treatment was started with a six-week course of oral doxycycline 200 mg/day and rifampicin 600 mg/day. This treatment regimen rapidly improved the patient's condition. Follow-up after one year showed no residual effects from the infection. CONCLUSION: Pulmonary involvement is a rare event in the course of brucellosis, but the rate could be higher than currently estimated. In endemic regions, brucellosis should be considered as a causative agent in patients with pulmonary symptoms.

HISTORIQUE: La brucellose est une zoonose causée par un bacille Gram négatif du gène Brucella associée à une atteinte multisystémique, touchant principalement le système réticuloendothélial, les articulations, le coeur et les reins. Même si la maladie peut se propager par inhalation, l'atteinte pulmonaire est rare. OBJECTIF: Rendre compte d'un cas de brucellose associé à une atteinte pulmonaire. PRÉSENTATION DE CAS: Une femme de 36 ans auparavant en santé a été hospitalisée parce qu'elle se plaignait de fièvre, de faiblesse, de sueurs nocturnes, d'une toux sèche et de douleurs thoraciques bilatérales. On lui avait diagnostiqué une pneumonie 20 jours auparavant et elle avait entrepris un traitement à la pénicilline de 14 jours, auquel elle n'avait pas répondu. L'auscultation pulmonaire a révélé un murmure vésiculaire réduit dans la zone inférieure ainsi que des craquements dispersés et des râles continus dans la zone inférieure de l'hémithorax droit. Les tests de Wright et de Coombs ont donné des titrages de 1:1 280 et de 1:640, respectivement. La radiographie pulmonaire a révélé une zone de condensation lobaire confluente dans le lobe inférieur droit. Le traitement a été amorcé par 200 mg/jour de doxycycline et 600 mg/jour de rifampicine par voie orale pendant six semaines, lequel a rapidement amélioré l'état de la patiente. Le suivi au bout d'un an n'a révélé aucun effet résiduel de l'infection. CONCLUSION: L'atteinte pulmonaire est rare dans l'évolution de la brucellose, mais le taux pourrait être plus élevé que les estimations actuelles. Dans les régions endémiques, la brucellose devrait être considérée comme un agent causal chez les patients présentant des symptômes pulmonaires.

Clinical and laboratory features, complications and treatment outcome of brucellosis in childhood and review of the literature.

Brucellosis, whether in an endemic region or not, remains a diagnostic puzzle due to occasional misleading unusual presentations and non-specific symptoms. The aim of this study was to evaluate the clinical and laboratory findings, complications and treatment outcome of brucellosis in children in southeastern Anatolia, Turkey. This study focuses on the frequency of clinical and laboratory findings and complications in cases with brucellosis. Of 22 patients, 8 (36.3%) were female and 14 (63.7%) were male. Fever, malaise, lack of appetite, arthralgia, and night sweating were the main presenting symptoms overall. Hematologic complications (n=13, 59.1%) were most common, followed by skeletal (n=7, 31.8%) and cutaneous system (n=1, 4.5%). Brucellosis may affect any organ system and imitate a variety of clinical entities. Diagnosis of brucellosis should be considered whenever there is a febrile illness associated with rheumatological complaints. Consequently, early recognition of the infection, prolonged antibiotic treatment and careful long-term follow-up should improve the patient outcome.