The presence of thrombocytopenia, high CRP and ESR levels, and high BC/CW titers was a diagnostic indicator of complicated brucellosis.
Abstract
Background
Human brucellosis remains a significant public health concern in northeastern Türkiye and is among the leading causes of visits to infectious disease clinics. In this study, we aimed to describe the clinical characteristics and laboratory findings of patients with brucellosis in high-burden regions, with a particular focus on identifying diagnostic indicators of complicated disease.
Methods
We conducted a retrospective study of patients with positive serology for brucellosis who were admitted to Harakani State Hospital in Kars between September 2022 and December 2023. Patients were grouped based on whether they had complicated or uncomplicated brucellosis. Potential diagnostic indicators of complicated brucellosis were identified using univariate and multivariate logistic regression.
Results
The study included 97 patients with a median age of 42 years; 41.2% were female. Rose Bengal and Brucellacapt/Coombs Wright (BC/CW) tests were positive in 94.8% and 98.9% of patients, respectively. Cases were classified as acute (55.7%), subacute (28.9%), and chronic (15.5%). Complicated brucellosis was identified in 33 patients (34%). In univariate analyses, complicated brucellosis was associated with thrombocytopenia (OR: 5.53; 95% CI: 1.01-30.29), elevated C-reactive protein (CRP) (OR: 5.9; 95% CI: 2.31-15.15), elevated erythrocyte sedimentation rate (ESR) (OR: 3.23; 95% CI: 1.14-9.18), and a BC/CW titer >1:320 (OR: 2.76; 95% CI: 1.13-6.72). Elevated CRP levels were observed in 43.3% of patients and remained independently associated with complicated brucellosis in multivariable analysis (adjusted OR: 4.36; 95% CI: 1.60-11.87). Relapse occurred in 13 patients (13.4%) within six months.
Conclusions
The presence of thrombocytopenia, high CRP and ESR levels, and high BC/CW titers was a diagnostic indicator of complicated brucellosis. Early identification of high-risk patients using combined clinical and laboratory parameters may improve follow-up strategies and clinical outcomes.
Aims: This study aimed to evaluate laboratory findings in patients with brucellosis in our region where livestock farming is widespread and to examine their contribution in diagnosis.Methods: 254 patients who presented to our hospital’s infectious diseases outpatient clinic with various complaints between 2017 and 2021, tested positive standard tube agglutination (STA), were included in the study. Patients were divided into two groups based on their STA titers: low titers (1/80 and 1/160) and high titers (≥1/320). These two groups were compared regarding demographic data, laboratory data, and symptoms at presentation.Results: According to STA titer, 93 patients (36.6%) had low titers, while 161 patients (63.4%) had high titers. The most common complaints were low back pain and with no significant difference between the two groups. The mean C-reactive protein (CRP) value was higher in the low titer group than in the high titer group, and a significant difference was found between the two groups. Erythrocyte sedimentation rate (ESR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) values were slightly higher in the low titer group than in the high titer group, but this difference was not statistically significant. Conclusion: Our study found that laboratory parameters such as CRP, ESR, NLR, and PLR were higher in patients with low titers compared to those with high titers, but significant difference was found only in CRP. Therefore, we believe that in addition to the STA test used in the diagnosis of brucellosis, other laboratory parameters can also assist the clinician in diagnosis.
Hülya Duran, Nihal Çeken, Tuba Kula Atik et al.· Journal of Health Sciences a...· 0 citations
Sustained high diphtheria positivity over 15 yr indicates ongoing transmission in parts of northern India, likely driven by immunity gaps due to suboptimal booster-dose coverage.
N. Sharma, Rajesh Ranjan, Kartikey Sharma et al.· The Indian journal of medica...· 0 citations
This case underlines the importance of considering brucellosis in febrile patients with livestock exposure, even in non-endemic settings, and presents a rare and severe respiratory form of brucellosis in a patient with occupational exposure to livestock.
Ondrej Zahornacký, Š. Porubčin, Alena Rovňáková et al.· The Egyptian Journal of Inte...· 0 citations
Background: Chronic pulmonary aspergillosis (CPA) is a recognized complication in patients with pulmonary tuberculosis, particularly in high TB burden regions. Misdiagnosis and inappropriate treatment occur due to overlapping clinicoradiological features, leading to increased morbidity and mortality. Data on CPA occurrence and its association with PTB in tertiary care settings remain limited in resource-constrained countries. Methods: This study enrolled 143 adults from outpatient and inpatient departments. Newly and previously diagnosed PTB patients were included. The CPA diagnosis was based on symptoms lasting over three months, radiological findings, and microbiological/immunological evidence using Aspergillus IgG and BAL galactomannan testing. Data were analyzed using STATA 14.0. Descriptive statistics summarized demographic and clinical data, and comparative analyses between CPA and non-CPA groups used chi-square or Fisher's exact tests for categorical variables and Student's t-test for continuous variables. Results: CPA was diagnosed in 34.3% (49/143) of PTB patients. The CPA cohort showed male predominance (male-to-female ratio, 4:1), with associations with diabetes mellitus (70.8%, p=0.038) and post-tuberculosis lung disease (61.4%, p=0.040). Radiological features, including cavitation (47.4%, p=0.009), aspergilloma (55.9%, p=0.009), and infiltrates (72.3%, p=0.10) were more frequent in CPA patients. Aspergillus-specific IgG was positive in 69.4% (p<0.001) and BAL galactomannan in 43.9% (p<0.001) of CPA patients. Conclusion: CPA is prevalent among PTB patients, especially those with TB history and comorbidities like diabetes. Integrated diagnostic approaches, including immunological and antigen testing, are recommended to improve differentiation and management in resource-limited settings.
Shivangi Priyadarshani, Satyadeo Choubey, Arshad Ejazi et al.· Nigerian Medical Journal· 0 citations
