Prevalence of Hematological Disorders among Children with Brucellosis
Keywords:Crescentic glomerulonephritis, post streptococcal glomerulo-nephritis chronic kidney diseases proteinuria, rapidly progressive glomerulonephritis, immune-complex disease
Background:Â Brucellosis is a zoonotic systemic infection due to infection by BrucellaÂ organisms with a various clinical manifestations and complications. Hematological disorders is the most common and serious complications among children. Objectives:Â Our study aimed to evaluate frequency of hematological complications among brucellosis infected children. Patients and Methods:Â All 75 patients enrolled in the study with fever more than 5 days, arthralgia , myalgia, low back pain , hematological disorders and positive serology test ( positive results when the tires > 1:80 ) were referred to the infectious diseases unit in King Khalid hospital ,Al-kharj city ,K.S.A. during Â April 2013 to August 2015, andÂ C.B.C., blood culture and bone marrow study were made for all patients .
Results:Â out of 75children with brucellosis with age 5-18 y, 63 (84%) gave a history of raw animal milk ingestion and 33 patients 44% had a positive family history of brucellosis. The commonly presenting symptoms and signs included; excessive sweating 43 patients (57.3%) bone aches 65 patients (62%) chills 40 patients (53.3%), arthritis 27 patients (36%). Hepatomegaly 10 patients (13.3%) and splenomegalyÂ Â Â Â 11 patients (14.6%). The most commonly detected hematological manifestations included; anemia in 34 patients (45%). leukopenia in 30 patients (40%) and leukocytosis in 18 patients (24%). Meanwhile, pancytopenia was detected in 24 patients (32%). Positive blood culture for brucella was seen in 30 patients (40%). B. melitensis from 26 patients (34.6%) was cultured in vitro. Out of 15 BM aspiration cultures, 5 were positive for B. melitensis while 10 cultures were negative. Out of 24 patients (32%) with pancytopenia, 17 patients 71% presented with bone aches and weakness, 12Â patients 50% presented with sweating and chills,12Â patients 50% Â had petechiae and purpura , 12 patients50% had splenomegaly and also 9 patients 37.5% had hepatomegaly.
Conclusions:Â Our study showed that the clinical manifestations and hematological disorders in children with brucellosis are 45% of patients were anemic, 40% were leukopenia, pancytopenia were in 32% while leukocytosis were in 24% similar to that in the adults; specially in endemic areas like K.S.A.Â
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