Brucellosis in Pediatric Populations – A Ten-Year Cohort Study

Background: Brucellosis is an endemic infection affecting the Mediterranean Basin, the Arabian Peninsula, India, Mexico, and South America. However, there is scant data on Brucellosis infections in children.

Objective: To review and characterize the clinical presentation of pediatric patients diagnosed with Brucellosis in a tertiary medical center.

Methods: Retrospective data analysis of all pediatric patients aged 0 to 18 years from January 2010 to December 2020 diagnosed with Brucellosis based on a positive serology test or the growth of Brucella bacteria in blood culture.

Results: Fifty-three children aged 0-18 years were included in this study. The mean age at presentation was 11.01±4.91 years. Most of the patients were males (39; 73.6.) Pre-infection exposure to unpasteurized milk or to unvaccinated livestock was reported in most of these children (37;69.8%). Fever was present in 64.6%. Arthralgia was present in 49% followed by loss of appetite and weight loss in 42.3% and 24.6% respectively. Gastrointestinal symptoms were reported in 52.8%. Eight patients had pancytopenia (15.1%). The median length of intravenous antibiotic treatment was 7 days (range 3-14 days); the median length of oral antibiotic treatment was 6 weeks (range 2-24 weeks). Two (3.7%) required PICU admission. No mortality was documented, and all cases of relapses were successfully treated.

Conclusion: pediatric Brucellosis is an acute febrile disease often associated with rheumatologic complaints. The "older" adolescent pediatric population aged 8-18 presented uniquely with additional symptoms of headache, weight loss and night sweats.