1887

Abstract

We investigated the incidence of and risk factors for liver involvement (LI) in patients with brucellosis in Turkey. Diagnosis was established by blood cultures (BCs) or compatible clinical presentation accompanied by serological evidence. Patients received either a combination of doxycycline plus rifampin for 6 weeks or doxycycline for 6 weeks plus streptomycin intramuscularly for the first 2 weeks. Liver function tests, including those for alanine (ALT) and aspartate aminotransferase (AST) levels, were monitored before and at the end of treatment. One hundred and ninety-five patients were included in the study. Seventy patients had elevated transaminases before treatment. Twenty-six patients had a positive BC for brucellosis. In multivariate analysis, BC positivity (OR=2.44, 95 % CI: 1.03–5.78, P=0.043) and serum agglutination titre (SAT) (OR=1.001, 95 % CI: 1.00–1.002, P=0.018) were found to be associated with LI. Serum aminotransferase levels were normalized in all patients with brucellosis. BC positivity and high SAT are independent factors that are associated with LI in patients with brucellosis.

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2018-07-04
2019-12-11
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References

  1. Dean AS, Crump L, Greter H, Schelling E, Zinsstag J et al. Global burden of human brucellosis: a systematic review of disease frequency. PLoS Negl Trop Dis 2012;6:e1865 [CrossRef][PubMed]
    [Google Scholar]
  2. Yumuk Z, O'Callaghan D. Brucellosis in Turkey – an overview. Int J Infect Dis 2012;16:e228e235 [CrossRef][PubMed]
    [Google Scholar]
  3. Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005;352:2325–2336 [CrossRef][PubMed]
    [Google Scholar]
  4. Akritidis N, Tzivras M, Delladetsima I, Stefanaki S, Moutsopoulos HM et al. The liver in brucellosis. Clin Gastroenterol Hepatol 2007;5:1109–1112 [CrossRef][PubMed]
    [Google Scholar]
  5. Buzgan T, Karahocagil MK, Irmak H, Baran AI, Karsen H et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis 2010;14:e469e478 [CrossRef][PubMed]
    [Google Scholar]
  6. Gür A, Geyik MF, Dikici B, Nas K, Cevik R et al. Complications of brucellosis in different age groups: a study of 283 cases in southeastern Anatolia of Turkey. Yonsei Med J 2003;44:33–44 [CrossRef][PubMed]
    [Google Scholar]
  7. Parlak M, Akbayram S, Doğan M, Tuncer O, Bayram Y et al. Clinical manifestations and laboratory findings of 496 children with brucellosis in Van, Turkey. Pediatr Int 2015;57:586–589 [CrossRef][PubMed]
    [Google Scholar]
  8. National Code on Clinical Research In: No: 28617. Turkey: Institution of Drugs and Medical Devices; 2013; pp.1–14
  9. Mert A, Ozaras R, Tabak F, Bilir M, Yilmaz M et al. The sensitivity and specificity of Brucella agglutination tests. Diagn Microbiol Infect Dis 2003;46:241–243 [CrossRef][PubMed]
    [Google Scholar]
  10. Kutlu M, Cevahir N, Erdenliğ-Gürbilek S, Akalın Ş, Uçar M et al. The first report of Brucella suis biovar 1 isolation in human in Turkey. J Infect Public Health 2016;9:675–678 [CrossRef][PubMed]
    [Google Scholar]
  11. Denk A, Demirdag K, Kalkan A, Ozden M, Cetinkaya B et al. In vitro activity of Brucella melitensis isolates to various antimicrobials in Turkey. Infect Dis 2015;47:364–369 [CrossRef][PubMed]
    [Google Scholar]
  12. Köse Ş, Serin Senger S, Akkoçlu G, Kuzucu L, Ulu Y et al. Clinical manifestations, complications, and treatment of brucellosis: evaluation of 72 cases. Turk J Med Sci 2014;44:220–223 [CrossRef][PubMed]
    [Google Scholar]
  13. Braude AI. Studies in the pathology and pathogenesis of experimental brucellosis. II. The formation of the hepatic granuloma and its evolution. J Infect Dis 1951;89:87–94 [CrossRef][PubMed]
    [Google Scholar]
  14. Guerra H, Deter RL, Williams RP. Infection at the subcellular level. I. Localization of intravenously injected brucellae in the vacuolar apparatus of cells of guinea pig liver. Infect Immun 1972;5:513–523[PubMed]
    [Google Scholar]
  15. Guerra H, Deter RL, Williams RP. Infection at the subcellular level. II. Distribution and fate of intravenously injected brucellae within phagocytic cells of guinea pigs. Infect Immun 1973;8:694–699[PubMed]
    [Google Scholar]
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