Retrospective Investigation Of 141 Brucellosis Cases

Objective:We research it in order to grasp promptly the clinical epidemiological situation and trend of Brucellosis in the first hospital of Shanxi Medical University, which may provide the basis for clinical diagnosis and treatment so as to reduce the misdiagnosis and missed diagnosis rate.Methods:A total of 141 brucellosis cases admitted to the first hospital of Shanxi Medical University during January 2013 to December 2015 were included in the study. A retrospective investigation was undertaken and patient files were reviewed for general situation, clinical and laboratory findings, the process of diagnoses and treatments, the short-term prognosis, in addition to the long-term prognosis. The data were collected and analyzed with Excel table, and summarized the characteristics of clinical epidemiology of brucellosis.Results:141 cases were involved in 8 regions of Shanxi province. The patients were mostly 51 to 60 years old that accounted for 34.75%. The mean age of the patients was 56 years and70.92% were male. The onset of peak time were appeared July to August each year. The ratio of occupational population to non occupational population was 3.86:1, among which112 cases(79.43%) were occupational groups. 87.23% of patients had clear history of exposure, and only 13.48% of those who got close contact with livestock took protective measures. With diverse symptoms and clinical manifestations, Only 10 patientsexperienced typical wave heat(7.09%) and 17 cases(12.06%) had typical migratory joint pain. A total of 84 cases(59.57%) occurred various complications in the development of the disease. However, the correctly first diagnosis was merely accounted for 21.99%. The shortest misdiagnosed time was 1 week, while the longest was 18 months. The total misdiagnosis rate was up to 78.01%. Adequate treatment with combination of antibiotics and supplemented by hepatoprotective drugs according to the specific circumstances, that the total cure rate was 92.20%.Conclusion:1. Extensive breakout is replacing by fragmented scattering point in the first hospital of Shanxi Medical University. Late summer and early autumn of each year is the peak time,while the patients is mainly in middle-aged and elderly men. Occupational population is the main, but there is a tendency to spread to the non professional population.2.With diverse symptoms and clinical manifestations, untypical cases increased significantly and the disease was prone to a variety of complications. The rate of misdiagnosis and missed diagnosis was high. However, the cure rate was higher after the standard antibacterial treatment.