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Diagnostic and therapeutic challenges of childhood brucellosis in a nonendemic country Shen MWPediatrics 2008[May]; 121 (5): e1178-83OBJECTIVE: We sought [corrected] to define the current epidemiology, clinical manifestations, and course of childhood brucellosis in the United States. METHODS: A retrospective chart review was performed of 20 patients who received a diagnosis of brucellosis over a period of 13 years at a large, tertiary care children's hospital in Dallas, Texas. Diagnostic criteria, epidemiology, clinical presentations, and outcomes were recorded. RESULTS: Ninety-five percent of the patients had a recent history of either travel to Mexico or ingestion of unpasteurized milk products from Mexico. Fever was an initial complaint in 80% of the patients, and 50% of the patients presented with arthritis. Diagnosis was made via the identification of Brucella melitensis in the blood cultures of 18 patients. Five patients experienced relapse, and 3 experienced treatment failure. CONCLUSIONS: Childhood brucellosis in the United States is now an imported disease, primarily from Mexico. In the context of this epidemiologic link, the diagnosis should be entertained for a patient who presents with signs of systemic inflammation and arthritis. Therapeutic challenges remain.|Adolescent[MESH]|Animals[MESH]|Brucella melitensis/isolation & purification[MESH]|Brucellosis/*diagnosis/drug therapy/*epidemiology[MESH]|Child[MESH]|Child, Preschool[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Mexican Americans[MESH]|Mexico[MESH]|Milk/microbiology[MESH]|Recurrence[MESH]|Texas/epidemiology[MESH]|Travel[MESH] |
