Clinical Features, Complications and Treatment Outcome of Brucella infection: Ten Years' Experience in an Endemic Area

Purpose: Brucellosis is a multi-systemic infection that is endemic in some parts of the world. The purpose of this study was to examine the epidemiology as well as the clinical and haematological characteristics, complications, and treatment outcome of patients with brucellosis at the King Fahd Hospital of the University Alkhobar, Saudi Arabia. Methods: A descriptive case assessment of all adult patients (aged 13 years and above) with brucellosis over a period of 10 years between 1998 and 2007 was undertaken. Results: The diagnosis of brucellosis in 84 patients was made by clinical findings, positive agglutination titre, and/or the isolation of Brucella species. The number of patients with brucellosis presenting at our hospital reduced over the study period, with a much smaller proportion of cases occurring after the year 2000. Most of the patients had fever (73%) and musculoskeletal symptoms (64%). Splenomegaly was recorded in 13% and hepatomegaly in 11% of patients. Seven patients (8%) had epididymo-orchitis. Two patients presented with fever of unknown origin with negative serology and only bone marrow culture was positive for Brucella mellitensis. Two patients presented with menstrual associated recurrent fever. One previously healthy patient presented with jaundice and spontaneous peritonitis. No therapeutic failure was observed but relapse occurred in six patients (7%). None of the patients who received streptomycin or ciprofloxacin as part of their antibiotic regimen had a relapse. Conclusion: Brucellosis has a wide range of clinical manifestations. Although the number of patients with brucellosis presenting at our hospital has reduced, continuous organized effort is necessary for brucellosis control