BRUCELLOSIS IN CHILDHOOD IN THE WESTERN CAPE

Human brucellosis, a multisystem disease which may mimic other conditi ons, has a low incidence in childhood and the diagnosis may easily be missed. Over a 7-month period 9 children with brucellosis presented to the Department of Paediatrics and Child Health, Tygerberg Hospital. S ix of the children had consumed unpasteurised milk. The main presentin g symptoms were fever, fatigue, headache, myalgia and haematuria. Clin ical signs included lymphadenopathy (3), nasopharyngitis (2), features of lower respiratory tract infection (2), splenomegaly (2) and pyrexi a (1). The diagnosis was made on the basis of a positive serological t itre (> 1:160) for Brucella abortus. The prozone phenomenon was encoun tered in 6 cases; however, the Coombs test confirmed the diagnosis in these cases. Children under 7 years were treated with co-trimoxazole a nd rifampicin and those over 7 years with tetracycline and rifampicin, for at least 6 weeks. No relapses were detected on follow-up.