ARE WE SEEING THE TIP OF AN ICEBERG? A FIVE YEAR STUDY OF HUMAN BRUCELLOSIS FROM A TERTIARY CARE HOSPITAL IN BANGALORE
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Brucellosis is a common zoonotic disease that exists worldwide. In India where agriculture is the predominant occupation, people are exposed to livestock and are prone to be infected. The non-specific symptoms that overlap with other diseases make it difficult for the clinician to diagnose, apart from the patient himself presenting late due to mild, non-aggressive symptoms. Brucellosis can also present as a well localized infection. There are not many studies from India focusing on
... India focusing on the clinical presentation or other unusual manifestations of the disease and hence the need for this study. The aim of the study was to evaluate the protean manifestations of Brucellosis with special emphasis on organ / localized involvement and to analyze the various lab parameters and treatment practices. MATERIALS AND METHODS This was a retrospective study done during 2012 to 2016 at MS Ramaiah Medical College and Hospitals, Bangalore. Patients diagnosed with brucellosis during this period were included in the study. Their records were analysed for information regarding history, occupation, clinical features, investigations, treatment received and course in the Hospital. RESULTS Records of sixteen patients were selected and studied. The average age of the subjects was 47.75 ± 16.5years. There were 13 (81.25%) male and 3 (18.75%) female patients. There was history of occupational exposure among 8(50%) patients. All subjects had history of fever. Ten (62.5%) had musculoskeletal symptoms. Neurological manifestations were present in 5 (31.25%) subjects. Abdominal examination revealed hepatomegaly (n=2, 12.5%), splenomegaly (n=5, 31.25), hepatosplenomegaly (n=1, 6.25%) and in one (6.25%) patient ascites. Two (12.5%) patients presented with multiple organ involvement. Blood investigations revealed anemia in 13 (81.25%), thrombocytopenia in 9 (56.25%) and elevated ESR in 7 (43.75%) patients. There were eleven (68.75%) patients with an abnormal LFT. Chest X ray was abnormal in 5 (31.25%) patients. Mean Brucella IgM titre was 4.18 ± 3.46 IU/ml. Different treatment protocols were followed. All patients recovered except for one who expired. CONCLUSION Brucellosis may present with multiple non-specific symptoms and signs or with localized organ involvement, often confusing the treating physician. A high index of suspicion is necessary to diagnose this condition. KEYWORDS Brucellosis, Organ Involvement, Treatment, Unusual Manifestation. HOW TO CITE THIS ARTICLE: Thyagaraj V, Shankar T, Sujatha KJ, et al. Are we seeing the tip of an iceberg? a five year study of human brucellosis from a tertiary care hospital in Bangalore. J. Evid. Based Med.