Brucellosis Suspicion is the Most Important Criterion for Diagnosis Particularly in Endemic Regions

Baris Yilmaz1, Guzelali Ozdemir1, Erdem Aktas2, Baran Komur3, *, Serdar Alfidan4, Serdar Memisoglu5, Tahir Mutlu Duymuş3
1 Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
2 Dr. A. Yurtaslan Ankara Onkology Training and Research Hospital, Ankara, Turkey
3 Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
4 Private Sifa Hospital, Isparta, Turkey
5 Private Primer Hospital, Gaziantep, Turkey

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© Yilmaz et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Turgut Ozal St. Halkali No. 1, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey; Tel: +90-212-5574000; Fax: +90-212-5714290; E-mail:



Brucellosis is a zoonotic infectious disease that remains endemic in developing countries. The purpose of this study is to emphasize the need for considering brucellosis as a diagnosis, since this disease has a high risk of complications among young patients when not treated appropriately.


A total of 88 brucellosis cases with blood cultures that were positive for the pathogen were evaluated retrospectively in this study.


The patients included 33 males (37.5%) and 55 females (62.5%) with a median age of 8.9 years (range: 5-14 years). A total of 43.1% (n=38) of the cases included occupational exposure to animals as a possible infection source. The consumption of raw milk products, especially cheese, was present in 52.2% (n=46) of the cases. Clinically, 55 of the cases were acute (62.5%), 23 of the cases were subacute (26.2%) and 10 of the cases were chronic (11.3%). The distribution of the joint pain complaints was as follows: 62.5% (n=55) of patients reported hip pain, 22.7% (n=20) of patients reported knee pain, 11.4% (n=10) of patients reported lumbar-back pain and 3.4% (n=3) of patients reported pain in other joints. A total of 59.1% (n=52) of the cases had been examined by another doctor at least once and mistreated.


Complication rates and the rate of chronic infection increase with delayed diagnosis, and clinical doubt is the most important criterion for diagnosis, particularly in endemic regions.

Keywords: Brucella, brucellosis, brucellosis in children, joint pain.