CLINICAL-IMMUNOLOGIC CHARACTERISTICS OF ACUTE BRUCELLOSIS IN CHILDREN

Authors

  • D. R. Atakhodjayeva Tashkent pediatric medical institute, Uzbekistan, Uzbekistan

DOI:

https://doi.org/10.14739/2310-1210.2013.6.20540

Keywords:

brucellosis, clinical immunology, cytokine status, children

Abstract

Background: Brucellosis is acute zoonotic, multi-systemic infection caused by  Brucella bacteria kind. Brucellosis is met everywhere on all continents of the world, especially in the countries where livestock sector is developed. Nowadays in spite of significant success in the struggle against brucellosis this infection is a social problem.

Brucellosis has specific clinical manifestations during various age periods. Problems interrelated with the study of the pathogenesis of brucellosis infection, particularly immune genesis, defining the progress and the outcome of the disease have great importance.

Object of the research: to study peculiarities of the progress of acute brucellosis in children taking into account clinical-immunologic data.

Materials and methods of the research: the research was based on the results of examinations of 23 children from 3 to 14 years old with brucellosis mostly living in endemic foci of the Republic of Uzbekistan. The diagnosis was defined based on epidemiologic anamnesis, clinical symptoms and laboratory data. All examined children got the analysis of detailed blood immunogramm.  The corresponding data of 20 healthy children served to be controlling ones.

Results and discussion: The analysis of epidemiologic anamnesis showed, that  78.3% of the examined patients with brucellosis were villagers keeping sheep, goats and cattle.  In 73.9% cases source of infection was sheep and goats, 8.7% - cattle, and  in 17.4% cases we could observe mixed type of infection.

78% of patients applied to hospital during prodromal period. Main complaints were weakness, frustration, headache, fatigue, bad appetite. These symptoms lasted not more than 3-5 days, after which there were symptoms of intoxication of organism with the rise of cardinal symptoms such as  fever with chill (100%), arthalgia (69%), slight sweating (70%), hepato-lienal syndrome (68%). 32.9% of patients had tachycardia. Objective visual examination showed enlargement of lymphatic nodes (submaxillary, inguinal and axillary) in 73.8% of children with brucellosis. That category of children had lymphatic nodes of average consistence, painless, from pea to a bean size. 79.1%  of patients had mild hypo chrome anemia.  65% of patients had acceleration of erythrocytes sedimentation rate of various degrees. On the part of white cells of blood 43.5% patients had explicit leukopenia and 21.7% - moderate one. 30.5% of patients had normal number of leukocytes. Leukocytosis was observed in 4.3% of children with acute brucellosis.

Patients with acute brucellosis had misbalance of cell-mediated and humoral immunities characterized by the decrease of T-cell and B-cell values of immunity accompanied by the activation of immunoglobulins (А, М, G).

In cases of acute brucellosis together with combined immune deficiency children had significant disorders of cytokines regulation displayed in statistic increase of pro- (IL-1β, IL-6) and counter inflammatory cytokines (IL-4, IL-10), and reliable decrease of  γ-interferons proving development of inflammatory process.

References

Аманфу В. Наблюдения за бруцеллезом и борьба с ним: роль ФАО / В. Аманфу, Ахмед Эль-Идрисси // Семинар по проблемам бруцеллеза людей и животных Казахстана, Узбекистана и Грузии (19–22 июня 2004 г.). – Алма-Ата, 2004.

Аманфуз В. Обзор эпидемиологии бруцеллеза в отдельных странах / В. Аманфуз, Д. Уорд, Л. Пите // Семинар по проблемам бруцеллеза людей и животных Казахстана, Узбекистана и Грузии (19–22 июня 2004 г.). – Алма-Ата, 2004.

Амиреев С.А. Применение социально-экологической концепции эпидемиологического процесса в изучении и борьбе с бруцеллезом / С.А. Амиреев, Т.А. Грушина // Эпидемиология и инфекционные болезни. – М., 2008. – № 1. – С. 35–38.

Ахмадбекова С.Ш. Ситуация по бруцеллезу в Таджикистане остаётся тревожной / С.Ш. Ахмадбекова, Х.Х. Махмадуллаев // Материалы международного рабочего совещания «Бруцеллез – пограничная инфекция животных и человека, требующая общих усилий разных стран» (2–3 июня 2008 г.). – Серпухов, 2008. – С. 5.

Ахмедова М.Д. Иммунная система у больных бруцеллезом /М.Д. Ахмедова. – Махачкала, 2007. – 169 с.

Григорян С.Л. Распространенность бруцеллеза в Республике Армения / С.Л. Григорян, А.Р. Мкртчян // Материалы международного рабочего совещания «Бруцеллез – пограничная инфекция животных и человека, требующая общих усилий разных стран» (2–3 июня 2008 г.). – Серпухов, 2008. – С. 45.

Желудков М.М. Эпидемиология бруцеллеза в России /

М.М. Желудков, Л.Е. Цирельсон, Ю.К. Кулаков // Сборник

материалов научно-практической конференции «Актуальные вопросы зоонозных инфекций». – Уланбатор, 2008. – С. 53–60.

Кулжанова Ш.А. Содержание интерферонов у больных бруцеллезом / Ш.А. Кулжанова, Л.А. Муковозова, Е.М. Смаилов // Наука и здравоохранение. – 2008. – С. 73–74

Покровский В.И. Эволюция инфекционных болезней в России в ХХ веке: рук. для врачей / В.И. Покровский, Г.Г. Онищенко, Б.Л. Черкасский. – М., 2003. – 664 с.

Behrman R.E. Nelson textbook of pediatrice / R.E. Behrman –17-th ed. – WB, Saunders, 2004.

Giannakopoulos I. Presentation of childhood brucellosis in western Greece / I. Giannakopoulos, N.M. Nikolakopoulou et al. // Jpn J Infect Dis. – 2006. – Vol. 59 (3). – P. 160–163.

Mantur B.G. Childhood brucellosis a microbiological, epidemiological and clinical study / B.G. Mantur, A.S. Akki et al. // J. Trop Pediatr. – 2004. – Vol. 50 (3). – P. 153–157.

Pappas G. Brucellosis / G. Pappas, N. Akritidis, M. Bosilkovski, E. Tsianos // N Engl J Med. – 2005. – Vol. 352 (22). – P. 2325–2336.

Rauchan M.R. Childhood brucellosis in Babol, Iran / M.R. Rauchan, S.A. Ahmadi et al. // Trop doct. – 2005. – Vol. 35 (4). – P. 229–231.

Salari M.H. Selected epidemiological features of human brucellosis in Yazd, Islamic Republic of Iran: 1993–1998 / M.H. Salari, M.B. Khalili, G.R. Hassanpour // East Mediterr Health J. – 2003. – Vol. 9(5–6). – P. 1054–1060.

Shaalan M.A. Brucellosis in children: clinical observations in 115 cases / M.A. Shaalan, Z.A. Memish, S.A. Mahmoud et al. // Int J Infect Dis. – 2002. – Vol. 6 (3). – P. 182–186.

Troy S.B. Brucellosis in San Diego: epidemiology and speciesrelated differences in acute clinical presentations / S.B. Troy, L.S. Rickman, C.T. Davis // Medicine. – Baltimore, 2005. – Vol. 84 (3). – P. 174–187.

How to Cite

1.
Atakhodjayeva DR. CLINICAL-IMMUNOLOGIC CHARACTERISTICS OF ACUTE BRUCELLOSIS IN CHILDREN. Zaporozhye Medical Journal [Internet]. 2014Jan.29 [cited 2024Oct.16];15(6). Available from: http://zmj.zsmu.edu.ua/article/view/20540

Issue

Section

Original research