Evaluation of epidemiologic, clinical, and paraclinical features of children with brucellosis hospitalized in two teaching hospital related to Mazandaran University of Medical Sciences, Iran, during the years 2010-2016

Salar Behzadnia, Narges Najafi, Kiana Marzban, Fatemeh Ahangarkani, Alireza Davoudi

DOI: 10.22122/cdj.v5i1.230


BACKGROUND: The clinical manifestations of brucellosis are very diverse. This study was conducted to investigate the epidemiological, laboratory, and clinical characteristics in pediatrics patients with brucellosis.

METHODS: In this descriptive cross-sectional study, the population included patients under age of 18 years who were hospitalized with a diagnosis of brucellosis in Razi hospital, Qaemshahr City, and Bu-ali Sina hospital, Sari City, Iran, during the years 2010-2016. Twenty seven patients with a mean age of 12.5 years including 9 girls and 18 boys had inclusion criteria and entered to study. Most patients (70.3%) were in the age range of 12-18 years.

RESULTS: Twenty one patients (77.8%) consumed unpasteurized dairy products and 10 patients (37%) had direct contact with livestock. Most of the initial complaints were fever in 13 cases (48.1%), joint pain in 12 cases (44.4%), and limbs pain in 5 cases (18.5%). The most common clinical findings were arthritis (14.8%) and splenomegaly (7.4%). In laboratory findings, 11.1% had leukopenia, 48.1% had anemia, 3.7% had thrombocytopenia, 29.6% had a moderate increase in erythrocyte sedimentation rate (ESR), 25.9% had high increase in ESR, and 18.5% had leukocytosis. Clinical signs and laboratory parameters in the study included chills and fever, joints and limbs pain, arthritis, splenomegaly, increase in ESR, anemia, leukocytosis, and leukopenia.

CONCLUSION: In patients with fever and skeletal or joints pain, brucellosis should be considered as a possible disease, and initial diagnostic measures should be taken, especially in children. Signs and symptoms of brucellosis are various and nonspecific. Educating the high risk families plays an important role in management of disease.



Brucellosis; Pediatrics; Epidemiology; Clinical Medicine

Full Text:



Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis 2006; 6(2): 91-9.

Al DS, Nockler K, Tomaso H, Splettstoesser WD, Jungersen G, Riber U, et al. Seroprevalence of brucellosis, tularemia, and yersiniosis in wild boars (Susscrofa) from north-eastern Germany. J Vet Med B Infect Dis Vet Public Health 2005; 52(10): 444-55.

Lecaroz C, Blanco-Prieto MJ, Burrell MA, Gamazo C. Intracellular killing of Brucellamelitensis in human macrophages with microsphere-encapsulated gentamicin. J Antimicrob Chemother 2006; 58(3): 549-56.

Mantur BG, Biradar MS, Bidri RC, Mulimani MS, Veerappa, Kariholu P, et al. Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years' experience in an endemic area. J Med Microbiol 2006; 55(Pt 7): 897-903.

Bouza E, Sanchez-Carrillo C, Hernangomez S, Gonzalez MJ. Laboratory-acquired brucellosis: A Spanish national survey. J Hosp Infect 2005; 61(1): 80-3.

Gerberding JL, Romero JM, Ferraro MJ. Case records of the Massachusetts general hospital. case 34-2008. A 58-year-old woman with neck pain and fever. N Engl J Med 2008; 359(18): 1942-9.

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in Globocan 2012. Int J Cancer 2015; 136(5): E359-E386.

Giannakopoulos I, Nikolakopoulou NM, Eliopoulou M, Ellina A, Kolonitsiou F, Papanastasiou DA. Presentation of childhood brucellosis in Western Greece. Jpn J Infect Dis 2006; 59(3): 160-3.

Yoldas T, Tezer H, Ozkaya-Parlakay A, Sayli TR. Clinical and laboratory findings of 97 pediatric brucellosis patients in central Turkey. J Microbiol Immunol Infect 2015; 48(4): 446-9.

Fanni F, Shahbaznejad L, Pourakbari B, Mahmoudi S, Mamishi S. Clinical manifestations, laboratory findings, and therapeutic regimen in hospitalized children with brucellosis in an Iranian Referral Children Medical Centre. J Health Popul Nutr 2013; 31(2): 218-22.

Aghaali M, Mohebi S, Heydari H. Prevalence of asymptomatic brucellosis in children 7 to 12 years old. Interdiscip Perspect Infect Dis 2015; 2015: 187369.

Tanir G, Tufekci SB, Tuygun N. Presentation, complications, and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009; 51(1): 114-9.

Afsharpaiman S, Mamishi S. Brucellosis: Review of clinical and laboratory features and therapeutic regimens in 44 children. Acta Med Iran 2008; 46(6): 489-94.

Bosilkovski M, Dimzova M, Grozdanovski K. Natural history of brucellosis in an endemic region in different time periods. Acta Clin Croat 2009; 48(1): 41-6.

SaeedSasan M, Nateghi M, Bonyadi B, Aelami MH. Clinical features and long term prognosis of childhood brucellosis in Northeast Iran. Iran J Pediatr 2012; 22(3): 319-25.

Armin S, Gharib A, Karimi A, Babaie D, MasoumiKashani N. Brucellosis in children: A disease with multiple features. J Pediatr Infect Dis 2007; 2(4): 219-23.

Hatami H, Hatami M, Souri H, Janbakhsh A, Mansouri F. Epidemiological, clinical, and laboratory features of brucellar meningitis: A study of 39 cases. Behbood 2010; 14(1): 7-81. [In Persian].

Ayazi P, Mahyar A, Rasoli A. Brucellosis in children. J Compr Ped 2012; 3(1): 12-5.

Davoudi AR, Najafi N, Hoseini SM, Ahangarkani F. Frequency of bacterial agents isolated from patients with nosocomial infection in teaching hospitals of Mazandaran University of Medical Sciences in 2012.Caspian J Intern Med 2014; 5(4): 227-31.

Rezai MS, Pourmousa R, Dadashzadeh R, Ahangarkani F. Multidrug resistance pattern of bacterial agents isolated from patient with chronic sinusitis. Caspian J Intern Med 2016; 7(2): 114-9.

Rezai MS, Bagheri-Nesami M, Hajalibeig A, Ahangarkani F. Multidrug and cross-resistance pattern of ESBL-producing enterobacteriaceae agents of nosocomial infections in intensive care units. J Mazandaran Univ Med Sci 2017; 26(144): 39-49. [In Persian].

Ahangarkani F, Rouhi S, GholamourAzizi I. A review on incidence and toxicity of fumonisins. Toxin Reviews 2014; 33(3): 95-100.

Sawadkohi R, Siadati S, Zoughi E. Evaluation of under 12 year-old patients with malta fever In Tehran Children Medical center & Amirkola Children Hospital, Babol-1995-99. J Mazandaran Univ Med Sci 2001; 11(33): 46-52. [In Persian].


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 4.0

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.