Human brucellosis in Crete, Greece

Abstract number: 1134_01_173

Kofteridis D., Milaki G., Alegakis D., Mazokopakis E., Christias E., Samonis G.

Background:  

Brucellosis is a zoonosis with a worldwide distribution and may present with a variety of clinical manifestations and complications. The aim of this study was to investigate the epidemiological and clinical features, the complications and the laboratory findings of brucellosis in adult patients during a 4-year period.

Methods:  

The medical records of 37 patients with brucellosis, hospitalized between 1998 and 2001 were retrospectively reviewed. The diagnosis was based on clinical symptoms, cultures and serological tests. Hepatitis was defined as elevated liver transaminase enzymes 2 times over the upper normal value.

Results:  

The mean age of the patients was 41 (median 33, range 15–79). Twenty-nine (78%) were males. Occupational exposure was mentioned by 54% while 64% had consumed unpasteurized diary products. The most frequent symptom was fever, observed in 34 (94%) with median duration 17 days (range 4–60). Other symptoms were sweating (66%), backache (45%), and malaise (18%). Focal disease was present in 16 patients (43%). The most common sites were spondilitis (24%) and sacroilitis (19%), epididymoorchitis (5%), erythema nodosum (5%) and meningitis (3%). Hepatitis was found in 6 patients (16%). The mean CRP value was 2.3 + 1.3 mg/dL. Leucopenia and thrombocytopenia were observed in 2 patients. Blood cultures were positive for brucella spp. in 74%. The organism was isolated from the cerebrospinal fluid in one patient (3%). All patients received combination treatment. Doxycycline and rifampin was the most common regimen (19 patients; 51%). Relapse occurred in 3 patients with osteoarticular disease who responded to second line therapy.

Conclusion:  

Brucellosis is endemic in Crete and presents mainly with fever, osteoarticular involvement and hepatitis. The outcome was favorable in most of the patients. Relapse was rare.