Clinical profile of Brucellosis

Abstract

Background: Since Brucellosis is one of the most common cause of FUO in this part of the world (25%) , as evidenced by a study conducted in SKIMS Srinagar in 2010. Keeping in view of this huge burden of the disease, the study was conducted to study the clinical profile of Brucellosis patients.

Objective: To study the demographic, clinical features, laboratory parameters and complications of Brucellosis.

Study Design: Prospective and retrospective hospital based study

Materials and Methods: Patients of Brucellosis of age group > 18 years who got admitted in our hospital were studied and observed for various demographic, clinical features, laboratory parameters and complications of Brucellosis. A total of 50 patients who met the inclusion criteria of Brucellosis were enrolled (38 men, 12 women) .

Results: Our study revealed that Brucellosis predominantly affects young people of age group 18-40 years (52%) with male predominance (76%) of rural population (74%) . Risk factor exposure was present in 94% of the patients with 76% having animal exposure and 16% having milk and milk product exposure. Most common presentation was acute with 74% presenting within 2 months of exposure and 26% presented in subacute stage. Fever with sweating, generalized weakness, arthralgia and body aches were the most common presenting symptoms. Among the signs, splenomegaly, hepatomegaly, hepatosplenomegaly and skeletal manifestations were predominant. ESR was high in 64% of the patients and Agglutination titres were high in all patients with maximum in the range of 1: 320 to 1: 640. Blood culture was positive in 22% of the patients. Most of the patients presented with uncomplicated Brucellosis (64%) , sacro-iliitis being the most common complication (16%) .

Conclusion: Brucellosis presents with a wide clinical spectrum, hence should be kept as a differential diagnosis in a patient of febrile illness with musculoskeletal aches and weight loss. Eradication of the disease in humans can only be achieved by the control of the disease in animals. This involves a multidisciplinary approach involving both patient education about the disease and its risk factors and livestock check up by a veterinarian especially if the animal is sick.

Implication: As the results of our study are in consistence with the meta-analysis of other studies done on Brucellosis, this study provides a broader perspective of how the patients of Brucellosis present and will help in early diagnosis and management of the patients.