We carried out a retrospective analysis of 283 patients diagnosed with brucellosis in our hospital, which serves almost 5.5 million inhabitants in Southeastern Anatolia in Turkey. Our study focuses on the frequency of complications in cases with brucellosis across different age groups. Patients were classified into three groups according to age: less than 15 years old (group A), 15-45 years old (group B) and over 45 years old (group C). Of 283 patients, 138 (49%) were female and 145 (51%) male. Fifty-three (19%) were younger than 15 years old (group A), 178 (63%) were 15-45 (group B), and 52 (18%) were over 45 (group C). When the distribution of all cases was examined according to months of the year, an increase was seen in June. Osteoarticular complications were the most frequent, found in 195 (69%) cases, followed by cutaneous (17%), genitourinary (8%), nervous (7%), respiratory (5%) and hematological (4%) complications. Treatment failed in 15 patients (5%), owing to true relapse in ten and to non-compliance and drug side effects in the other five. Two hundred seventy-two patients received medical treatment alone and 11 required medical and surgical treatment as well (9 spondylitis and 2 carditis). Complications in brucellosis were frequent because 25% of all patients with brucellosis had more than one complication, more so in group C (38%) than in group A (28%) or B (20%). Cutaneous, hematological and respiratory complications in childhood; osteoarticular and cardiac complications in adults; and genitourinary, neurological and gastrointestinal complications in middle aged were more prominent. In conclusion, the frequency of brucella complications was variable in different age groups in Southeastern Anatolia of Turkey. Since brucellosis is a preventable disease, knowledge and early diagnosis of the complications are especially important. Therefore, population education and medical precautions are necessary to prevent the harmful effects of brucella and its complications. In addition, primary health care physicians should be alerted regarding the clinical and laboratory findings of brucella complications.
Adolescent ; Adult ; Aging/*physiology ; Brucellosis/*complications/*physiopathology ; Female ; Human ; Male ; Middle Aged ; Retrospective Studies ; Turkey

The aim of this study was to evaluate the characteristics of patients with acute bacterial meningitis (ABM) developed secondary to acute and chronic otitis media (OM). Between 1991 and 2001, among 269 adult patients with ABM, 56 who were secondary to OM were included in the study. We reviewed the charts of patients who were diagnosed as ABM following acute or chronic OM. Risk factors associated with mortality were determined by using a logistic regression model. The mean age of the patients, 38 male and 18 female, was 25.8 +/- 10.8 years (range 14 - 65). Forty-four of these cases (79%) have had chronic OM, of whom 19 (43% of the 44) have also had chronic mastoiditis and 12 (27% of the 44) acute OM. Twenty-three patients (41%) died, during either hospitalization or the follow-up period. Univariate analysis revealed comatose mental status on admission, inappropriate antibiotic treatment before admission, and elevated erythrocyte sedimentation rate (ESR) as significant risk factors for mortality. In multifactorial analysis, comatose mental status (OR=42.5, CI=6.4-280.1, p=0.001) and elevated ESR (OR=1.0, CI=1.01-1.07; p=0.005) remained as significant predictors for mortality. In conclusion, the primary sources of infection leading to the development of ABM should be investigated carefully to reduce the morbidity and mortality rates. It is hoped that this study will raise awareness among general practitioners and otolaryngologists concerning the role of ABM as one of the most important complications of OM.
Acute Disease ; Adolescent ; Adult ; Aged ; Bacteria/isolation & purification ; Blood Sedimentation ; Female ; Human ; Male ; Meningitis, Bacterial/diagnosis/drug therapy/*etiology ; Middle Age ; Otitis Media/*complications/mortality ; Retrospective Studies ; Tomography, X-Ray Computed