• Noam Savion, Noa Guzner, Saar Hashavya, Shimon Reif, and Lea Ohana Sarna Cahan.
• Department of Pediatrics, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel.
• Isr Med Assoc J. 2023 Aug 1; 25 (8): 542546542-546.

BackgroundBrucellosis is an endemic infection affecting the Mediterranean Basin, Arabian Peninsula, India, Mexico, and South America. Data on brucellosis infections in children are limited.ObjectivesTo review and characterize the clinical presentation of pediatric patients diagnosed with brucellosis in a tertiary medical center.MethodsRetrospective data analysis was conducted on all pediatric patients from January 2010 to December 2020 admitted to the pediatric department with a diagnosis of brucellosis based on a positive serology test or growth of Brucella bacteria in blood culture.ResultsThe study comprised 53 children aged 0-18 years. The mean age at presentation was 11.01 ± 4.91 years; 39 male (73.6%). Pre-infection exposure to unpasteurized milk or unvaccinated livestock was reported in 37 (69.8%). Fever was present in 64.6%, followed by arthralgia (49%), loss of appetite (42.3%), and weight loss (24.6%). Gastrointestinal symptoms were reported in 52.8% and included abdominal pain (34.6%), nausea (28.3%), vomiting (24.5%), and diarrhea (2.6%). Eight patients experienced pancytopenia (15.1%). The median length of intravenous antibiotic treatment was 7 days (range 3-14 days) and for oral antibiotic treatment 6 weeks (range 2-24 weeks). Most patients were initially treated with intravenous gentamycin (90.5%) and long-term oral antibiotics, most commonly doxycycline. Two (3.7%) required admission to the pediatric intensive care unit. No mortality was documented, and all cases of relapses were successfully treated.ConclusionsPediatric brucellosis is an acute febrile disease often associated with rheumatologic complaints. Patients 8-18 years of age also presented with headache, weight loss, and night sweats.

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