Brucellosis; Difficulty of Diagnosis in Endemic Areas

Introduction: Brucellosis is a zoonotic disease distributed worldwide and very important public health problem especially in the developing countries. In this study, we aimed to evaluate the clinical/laboratory findings of brucellosis patients and contribute of coombs testing to diagnosis at Iğdır State Hospital infection diseases and clinical microbiology department. Materials and Methods: One hundred and forty-five brucellosis patients followed up in our clinic between September 2012 and February 2013 were evaluated retrospectively. Demographic characteristics, laboratory findings, diagnostic methods of the patients were presented. Results: The mean age of the patients were 39±15 (18-80) and 59% (n=86) of the patients were female, 41% (n=59) were male. Most frequent risk factors were animal breeding (n=115, 79%) and using underdone milk and milk products (n=98, 69%). Most reported complaints were weakness (92%), arthralgia (89%), sweating (74%), lack of appetite (70%) and fever (68%). Fifty-seven of the brucellosis patients could not diagnosed with standard tube agglutination. Therefore, Coombs test was used for these undiagnosed patients (39%, n=57). Eighty patients were evaluated as acute (55%), 53 as subacute (37%) and 12 as chronic (8%) brucellosis. Conclusions: Brucellosis can affect all organ systems and cause different clinical manifestations. Therefore, difficulties are encountered in the diagnosis of the disease. Brucellosis should be kept in mind in the differential diagnosis especially in the endemic regions. When the clinical suspicion exists detailed laboratory evaluation must be performed. Giriş: Bruselloz tüm dünyada yaygın olarak görülen zoonotik bir hastalıktır ve özellikle gelişmekte olan ülkelerde çok önemli bir halk sağlığı sorunudur. Bu çalışmada, Iğdır Devlet Hastanesi enfeksiyon hastalıkları ve klinik mikrobiyoloji bölümünde bruselloz hastalarının klinik/laboratuvar bulgularının ve coombs testinin tanıya katkısının değerlendirilmesi amaçlandı. Materyal ve Metod: Eylül 2012-Şubat 2013 tarihleri arasında kliniğimizde izlenen 145 bruselloz hastası geriye dönük olarak değerlendirildi. Hastaların demografik özellikleri, laboratuvar bulguları, tanı yöntemleri sunuldu. Bulgular: Hastaların yaş ortalaması 39±15 (18-80) olup, hastaların %59'u (n=86) kadın, %41'i (n=59) erkekti. En sık görülen risk faktörleri hayvancılık (n=115, %79) ve az pişmiş süt ve süt ürünleri kullanmaktır (n=98, %69). Bildirilen şikayetlerin çoğu halsizlik (%92), artr