Brucellosis has become a major medical problem in Israel particularly in the Muslim Arab population.
Eighty-eight children with acute brucellosis are described.
Sixty-seven were studied retrospectively during 1987 through 1988, and 21 children were studied prospectively during 1989 through 1992.
Epidemiologic, clinical and laboratory features were evaluated, and the outcome of 4 antimicrobial regimens are compared.
Although the clinical manifestation varied, the classical triad of fever (91%), arthralgia or arthritis (83%) and hepato-and/or splenomegaly (63%) characterized most patients.
Sixty-one percent of the children had elevated liver enzymes.
Brucella melitensis was isolated from 61% of blood cultures.
The relapse rate in patients who were treated with monotherapy (doxycycline) was 43% compared with 14% with regimens of combined therapy with rifampin and doxycycline, streptomycin and doxycycline or rifampin and trimethoprim-sulfamethoxazole (P<0.049).
Eleven children (33%) who were treated for 3 weeks had relapse compared with 1 patient (3.5%) treated for 4 weeks or longer.
The total relapse or reinfection rate was 20%. All patients with relapse recovered after a second course of antibiotic therapy.
During the 2 years of follow-up one child progressed to chronic osteomyelitis.
Mots-clés Pascal : Brucellose, Bactériose, Infection, Antibiotique, Epidémiologie, Traitement, Chimiothérapie, Enfant, Homme, Israël, Asie, Association médicamenteuse
Mots-clés Pascal anglais : Brucellosis, Bacteriosis, Infection, Antibiotic, Epidemiology, Treatment, Chemotherapy, Child, Human, Israel, Asia, Drug combination
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0379665
Code Inist : 002B05B02M. Création : 10/04/1997.