Brucellosis in children: clinical observations in 115 cases

Int J Infect Dis. 2002 Sep;6(3):182-6. doi: 10.1016/s1201-9712(02)90108-6.


Objective: Brucellosis is endemic in Saudi Arabia. This report summarizes the epidemiology of brucellosis in children.

Method: A retrospective review was made of medical records of all patients admitted to King Fahad National Guard Hospital with brucellosis during the period from 1984 to 1995.

Results: Children < or =12 years constituted 115/545 (21%) of the total brucellosis admissions. The mean age was 5.8 years and 64% of the patients were males. Consumption of unpasteurized milk (often from camel) was the main source of infection. In 70% the clinical picture was dominated by arthritis, 20% of patients presented with a non-specific febrile illness without localizing signs, and 10% had a febrile illness with uncommon presentations. Brucella serology was most helpful in making an early diagnosis. Initial titers of >1:640 were found in 90% of the cases. Bacteremia was observed in 45% and of the isolates speciated, 96% were Brucella melitensis. No increase in resistance to commonly used antimicrobials was noted during the 12-year study period. A combination of rifampin plus co-trimoxazole with or without streptomycin was used in two thirds of the patients. The overall rate of relapse was 9% and one patient died from neurobrucellosis.

Conclusion: Brucellosis presents in various ways and should be included in the differential diagnosis of arthritis in endemic countries. Prevention should rely on education including on boiling raw milk.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Brucella melitensis / drug effects
  • Brucella melitensis / isolation & purification*
  • Brucellosis / diagnosis
  • Brucellosis / drug therapy
  • Brucellosis / epidemiology*
  • Brucellosis / physiopathology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Retrospective Studies
  • Saudi Arabia / epidemiology


  • Anti-Bacterial Agents