CHILDHOOD BRUCELLOSIS IN NORTH-WESTERN GREECE - A RETROSPECTIVE ANALYSIS

Fifty-two cases of childhood brucellosis which occurred in north-weste rn Greece during the 15-year period 1979-1993, are reviewed. It is bel ieved that they represent very closely the total incidence of the dise ase in the region which has a population of 100,000 children aged 0-14 years old. Brucellosis-affected children were almost exclusively from goat- or shepherd families and of both sexes and all age groups. A br oad spectrum of clinical manifestations ranging from malaise only to b rain abscess was observed. Fever and arthralgia were the most common m anifestations followed by malaise, myalgia, sweating, rash, cough, and gastro-intestinal, cardiac and CNS involvement. Splenomegaly was foun d more often than hepatomegaly and lymphadenopathy. Laboratory finding s included anaemia, leukopenia, neutropenia, lymphocytopenia, monocyto sis, eosinophilia, thrombocytopenia and pancytopenia. Leukocytosis and lymphocytosis were extremely rare and ESR and serum C-reactive protei n levels were mildly elevated. All patients had positive Rose Bengal s lide agglutination tests and standard tube agglutination titres of 1:1 60 or more. When performed, blood culture was often diagnostic, The ch ildren were treated with streptomycin for 2 weeks plus either tetracyc lines or trimethoprim-sulphamethoxazole for 3 weeks. Treatment was wel l tolerated. Relapse was observed in one case. Conclusion Brucellosis nowadays affects children in an occupational pattern. As symptoms, sig ns and first-line laboratory findings are not characteristic, agglutin ation tests and blood culture should be performed in any child with pr olonged fever. Treatment is effective, but prevention of the disease b y animal testing and education of high risk families is indicated.