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Microbes & Immunity Childhood brucellosis in Saudi Arabia

Table 1. Patients’ demographics
Characteristic Total (n=20) Younger group (n=9) Older group (n=11)
Age (years) 8.9±5.1 (1 – 17) 4.5±1.9 (1 – 7) 10.1±2.9 (8 – 17)
Sex (male) 13 (65) 7 (77.8) 6 (54.5)
Location
Outpatient 11 (55) 4 (44.4) 7 (63.6)
Inpatient medical ward 9 (45) 5 (55.6) 4 (36.4)
Temperature (°C) 37.9±1.1 (36 – 39.5) 37.9±1.2 (36 – 39) 37.9±0.9 (36.8 – 39.4)
White blood cell count, cells/mm 3 6.7±2.1 (3.3 – 10.6) 6±1.7 (3.3 – 8.9) 7.7±2.7 (5.2 – 10.6)
C-reactive protein (mg/L) 29±38.9 (3 – 169) 11.3±11.7 (3 – 39.7) 42.5±58.1 (3 – 169)
Erythrocyte sedimentation rate (mm/h) 33.8±19.5 (7 – 70) 38.8±23.4 (9 – 70) 28.6±15.5 (7 – 44)
ALT (U/L) 64.4±54.6 (12 – 252) 77.4±73 (19 – 252) 46.4±39.7 (12 – 116)
AST (U/L) 65.8±43.2 (8 – 155) 64.3±28.6 (27 – 102) 58.3±53.8 (8 – 152)
Risk factors for infection
Consumption of unpasteurized dairy products 6 (30) 3 (33.3) 3 (27.3)
Unknown 14 (70) 6 (66.7) 8 (72.7)
Diagnostic test positivity
Brucella serology alone 10 (50) 4 (44.4) 6 (54.5)
Both Brucella serology and culture 10 (50) 5 (55.6) 5 (45.5)
Brucella spp.
B. melitensis 1 (5) 1 (11.1) 0 (0)
B. abortus 1 (5) 0 (0) 1 (9.1)
Both 18 (90) 8 (88.9) 10 (90.9)
Presence of co-infection 5 (25) 1 (11.1) 4 (36.4)
Presence of arthralgia 10 (50) 4 (44.4) 6 (54.5)
B. melitensis antibody titer >1:1280 (1:640 – >1:1280) >1:1280 (1:480 – >1:1280) >1:1280 (1:640 – >1:1280)
B. abortus antibody titer 1:640 (1:320 – >1:1280) 1:640 (1:320 – >1:1280) > 1:1280 (1:640 – >1:1280)
Notes: Data are presented as mean±SD (range) or n (%), except for the antibody titers, which are presented as median (interquartile range).
Abbreviations: ALT: Alanine transaminase; AST: Aspartate transaminase; B. abortus: Brucella abortus, B. melitensis: Brucella melitensis.

is considered the major mode of zoonotic transmission of good indicator of the presence of the disease, along with
brucellosis to humans. 2,5 signs and symptoms compatible with Brucella arthritis in a
community where Brucella is common.
Brucellosis is a multisystem disease with a broad
spectrum of non-specific signs and symptoms. This Brucellosis could also affect any organ or system. Apart
study found that fever and arthritis or arthralgia were the from two patients who had organ involvement – one had
predominant presenting signs of the disease. This finding neurobrucellosis, and the other had testicular involvement
was in line with previous studies from endemic areas, such – the current study revealed that the majority of patients
as Iran. Moreover, brucellosis-associated arthritis was had uncomplicated brucellosis. Notably, neurobrucellosis
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previously reported in children older than 8 years. 11-13,17 is not common among children, with an epidemiological
Although 48% of cases were detected only by the SAT study reporting an incidence of only 1% among children
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serological tests, doctors are advised to have a high index with brucellosis. Although Brucella spp. can cause
of suspicion for Brucella culture since the symptoms in endocarditis and urinary tract infections, 2,18,19 the reported
children might be mistaken for septic arthritis. In areas cases of rheumatic fever and urinary tract infections were
where brucellosis is widespread, such as Saudi Arabia, caused by pathogens other than Brucella spp.
persistent exposure to the source of infection increases Our study reported that 52% of the patients were
the titer value in which brucellosis is said to be established diagnosed using the SAT along with blood Brucella culture.
as a disease. In such areas, a titer of 1:640 or higher is a A recent study reported a lack of correlation between

Volume 2 Issue 1 (2025) 73 doi: 10.36922/mi.4634