Retrospective Analysis Of Clinical Characteristics Of 139 Patients With Brucellosis

Objective:Brucellosis is a zoonotic infectious disease caused by Brucella infection.At present,the incidence is on the rise,and it is often misdiagnosed due to the diversity and complexity of its clinical manifestations.Especially when the lumbar spine is involved by brucellosis,it is similar to tuberculous spondylitis in clinical manifestations,disease evolution,laboratory and imaging examinations,and it is often difficult to identify in clinical practice.This paper aims to summarize the clinical characteristics of brucellosis,misdiagnosis,and the identification of mycobacterium tuberculosis infection,so as to strengthen the understanding of clinical doctors on brucellosis,reduce the misdiagnosis rate and improve the diagnosis and treatment rate.Methods:The medical records of 139 inpatients diagnosed with brucellosis from 2015 to 2019 in the Third Hospital of Hebei Medical University were collected.The included 139 patients were divided into acute phase(course of disease < 3 months),subacute phase(course of disease 3-6months)and chronic phase(course of disease > 6 months)according to the course of disease.Demographic characteristics,exposure history,month of onset,clinical symptoms and signs,affected sites,and laboratory tests were summarized and analyzed.Results:In this study,male patients(74.82%)were significantly higher than female patients.The onset age was concentrated in 50–64 years old(51.8%).The peak month of the disease was from March to May(38.13%).Farmers were the main occupation(79.14%).The majority of patients(74.10%)had a clear history of exposure.Systemic symptoms such as fever(77.70%)and excessive sweating(24.69%)were more common in the acute phase,while in the chronic phase,the lower back pain(48.92%)and osteoarticular pain(29.50%)were more common.Atypical clinical manifestations such as testicular swelling,rash,and auditory hallucinations are seen in a few patients.Osteoarticular involvement(81.29%)was the most common involved site,and the lumbar spine was the first affected site(53.96%).In addition,the respiratory system,digestive system,genitourinary system,central nervous system,blood system and skin are also affected.The laboratory tests mainly included increased erythrocyte sedimentation rate(84.89%)and increased C-reactive protein(84.17%).No obvious abnormality was found in most of the routine blood tests and liver functions tests,and the positive rate of bacterial culture was 46.67%.Conclusions:We should be familiar with the epidemiological characteristics and clinical manifestations of brucellosis,especially the atypical clinical manifestations of local organ damage.Strengthen the differential diagnosis of patients with lumbar involvement to reduce misdiagnosis.Special attention should be paid to the differentiation between brucellosis spondylitis and tuberculous spondylitis.For patients who are definitely infected with Brucella,the possibility of complicated with Mycobacterium tuberculosis infection should be ruled out at the same time,so that early diagnosis and standardized treatment can be achieved.