河北省17例儿童布鲁氏菌病流行特征及临床特征分析

目的 探讨河北省17例儿童布鲁氏菌病的流行病学和临床特点,为河北省儿童布鲁氏菌病的诊断与防治提供参考。方法 回顾性分析河北省儿童医院17例诊断为布鲁氏菌病患儿的流行病学特点、临床特点、辅助检查、诊断及治疗情况。结果 70.59%的患儿为男孩,47.06% 的患儿年龄大于6岁,94.12%的患儿来自农村,52.94%的患儿有牛羊接触史,另有2例有狗接触史,64.71% 的患儿首发症状为不明原因发热,70.59% 的患儿从发病到确诊所经历的时间≤1月。最常见的临床症状是发热,其次为关节疼痛或活动障碍。最常见的体征是咽充血,其次是肝和/或脾脏肿大。未发现并发脑膜炎、脑膜脑炎、心内膜炎和睾丸炎的患儿。大部分患儿白细胞计数和血小板计数正常,但淋巴细胞比例增高、贫血、CRP升高、血沉增快、转氨酶升高和肌酸激酶升高较常见。影像学检查中关节腔积液和肺纹理增多增粗最常见。结论 河北省布鲁氏菌病患儿多来自农村,男孩多见,暴露史多为牛羊接触史,大部分患儿以不明原因发热伴或不伴肢体/关节疼痛就诊,临床症状多样且不典型。

Epidemiological and clinical characteristics of 17 children with brucellosis in Hebei Province

To provide a theoretical basis for clinical diagnosis and treatment,the epidemiological and clinical characteristics of children with brucellosis in Hebei Province were investigated.The epidemical features,clinical characteristics,laboratory and imaging findings,diagnosis and treatment of 17 children with brucellosis were retrospectively analyzed.Of the children with brucellosis,70.59%were boys,47.06%were older than 6 years old,94.12%were from the countryside,52.94%had exposure to cattle and sheep,and 2 cases had exposure to dogs,the first symptoms of 64.71%of children were fever of undetermined origin,the time from onset to diagnosis of 70.59%of children were less than 1 month.The most common clinical symptoms were fever,followed by joint pain or activity obstacle.The most common signs were pharyngeal hyperemia,followed by the hepatosplenomegaly,hepatomegaly or splenomegaly.No meningitis,meningoencephalitis,endocarditis and orchitis were observed.Most of the children were present with normal leukocyte and platelet count,however the lymphocytosis,anemia,elevated CRP,elevated erythrocyte sedimentation rate,elevated transaminases,and elevated creatine kinase were commonly found.Joint effusion and pulmonary texture increasing were the most common in terms of imaging findings.In conclusion,children with brucellosis in hebei province are mostly from rural areas and most of them are boys.Exposure history to cattle and sheep was most commonly observed.Most patients visited to a doctor were shown in atypical clinical symptoms with fever of undetermined origin,with or without body/joint pain.