Background and Aims: Brucellosis is endemic in southern Israel. We characterized the epidemiological, diagnostic and clinical aspects of children
Method and Patients: a retrospective study on children hospitalized with Brucellosis and diagnosed by a typical clinical picture and positive blood cultures. Patients with hematological manifestations (PHM) were compared with patients without hematological involvement (PwHM).
Results: 252 children with Brucellosis were admitted; of them, 128 (50.8%, all Moslem Bedouins) had positive blood cultures for B. melitensis. Thirty-three (25.8%) were diagnosed with hematological manifestations (32 with leukopenia, 14 with thrombocytopenia, 13 with both). More females were diagnosed among PwHM (77.9% vs. 25%, P=0.0005). No differences were recorded between PHM and PwHM in use of non-pasteurized milk, contact with livestock and Brucellosis among family members. Recurrent disease was more frequent in PwHM vs. PHM (10.4% vs. 0%, P=0.06). The most common presentations at admission were monoarthritis, lymphadenopathy and hepatomegaly (36.7%, 17.2% and 12, 5%, respectively), with no differences between the 2 groups. Impaired liver function tests were more frequent in PwHM vs. PHM (42.5% vs. 9.2%, P=0.005). Negative Brucella serological tests were reported in 9% and 10.5% PHM and PwHM, respectively. High antibodies titers (1:640-1:1280) were more common in PwHM (28.4% vs. 6%, P=0.002). All children recovered.
Conclusions: Brucellosis accompanied by hematological manifestations is common in southern Israel. PHM have a number of different characteristics compared with PwHM. We recommend testing for Brucellosis in all Bedouin children with leukopenia and/or thrombocytopenia in southern Israel.
