1. Liver involvement in patients with brucellosis: results of the Marmara study
- Author
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D. Ozturk-Engin, H. Erdem, S. Gencer, S. Kaya, A. I. Baran, A. Batirel, R. Tekin, M. K. Celen, A. Denk, S. Guler, M. Ulug, H. Turan, A. U. Pekok, G. Mermut, M. Tasbakan, N. Tulek, Y. Cag, A. Inan, A. Yalci, C. Ataman-Hatipoglu, I. Gonen, A. Dogan-Celik, F. Bozkurt, S. Gulsun, M. Sunnetcioglu, T. Guven, F. Duygu, E. Parlak, H. Sozen, S. Tosun, T. Demirdal, E. Guclu, O. Karabay, N. Uzun, O. Gunal, H. Diktas, A. Haykir-Solay, A. Erbay, C. Kader, O. Aydin, A. Erdem, N. Elaldi, A. Kadanali, Z. Yulugkural, L. Gorenek, M. Altındis, S. Bolukcu, C. Agalar, N. Ormeci, Ozturk-Engin, D, Erdem, H, Gencer, S, Kaya, S, Baran, AI, Batirel, A, Tekin, R, Celen, MK, Denk, A, Guler, S, Ulug, M, Turan, H, Pekok, AU, Mermut, G, Tasbakan, M, Tulek, N, Cag, Y, Inan, A, Yalci, A, Ataman-Hatipoglu, C, Gonen, I, Sakarya Üniversitesi/İlahiyat Fakültesi/Temel İslam Bilimleri Bölümü, Kaya, Süleyman, [Ozturk-Engin, D. -- Inan, A. -- Bolukcu, S.] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erdem, H. -- Gorenek, L.] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Gencer, S. -- Batirel, A. -- Cag, Y.] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kaya, S. -- Gulsun, S.] Diyarbakir Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Baran, A. I. -- Sunnetcioglu, M.] Yuzuncu Yil Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Van, Turkey -- [Tekin, R. -- Celen, M. K. -- Bozkurt, F.] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Denk, A.] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Guler, S.] Yenisehir State Hosp, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Ulug, M.] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Turan, H.] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Pekok, A. U.] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Mermut, G. -- Tosun, S.] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Kaya, S.] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Tasbakan, M.] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Tulek, N. -- Ataman-Hatipoglu, C.] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Yalci, A.] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Gonen, I.] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Dogan-Celik, A. -- Yulugkural, Z.] Trakya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Edirne, Turkey -- [Guven, T.] Yildirim Beyazit Univ, Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Duygu, F. -- Gunal, O.] Gaziosmanpasa Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Tokat, Turkey -- [Parlak, E.] Ataturk Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Erzurum, Turkey -- [Sozen, H.] Sitki Kocman Univ, Sch Med, Dept Anesthesiol & Reanimat, Mugla, Turkey -- [Demirdal, T.] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Guclu, E. -- Karabay, O.] Sakarya Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Sakarya, Turkey -- [Uzun, N.] Sisli Etfal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Diktas, H.] Tatvan Mil Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Haykir-Solay, A.] Igdir State Hosp, Dept Infect Dis & Clin Microbiol, Igdir, Turkey -- [Erbay, A. -- Kader, C.] Bozok Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Yozgat, Turkey -- [Aydin, O.] Medeniyet Univ, Dept Infect Dis & Clin Microbiol, Goztepe Training & Res Hosp, Istanbul, Turkey -- [Erdem, A.] Medeniyet Univ, Dept Pathol, Goztepe Training & Res Hosp, Istanbul, Turkey -- [Elaldi, N.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Kadanali, A.] Umraniye Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Altindis, M.] Sakarya Univ, Sch Med, Dept Clin Microbiol, Sakarya, Turkey -- [Agalar, C.] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ormeci, N.] Ankara Univ, Sch Med, Dept Gastroenterol, TR-06100 Ankara, Turkey, Gencer, Serap -- 0000-0002-3217-6305, Altindis, Mustafa -- 0000-0003-0411-9669, GENCER, SERAP -- 0000-0002-3217-6305, Elaldi, Nazif -- 0000-0002-9515-770X, and Karabay, Oguz -- 0000-0003-0502-432X
- Subjects
Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Anemia ,Gastroenterology ,Brucellosis ,Hepatitis ,Young Adult ,Internal medicine ,medicine ,Animals ,Humans ,Leukocytosis ,Transaminases ,Retrospective Studies ,Doxycycline ,Leukopenia ,business.industry ,Bilirubin ,General Medicine ,Middle Aged ,medicine.disease ,Pancytopenia ,Surgery ,Anti-Bacterial Agents ,Infectious Diseases ,Treatment Outcome ,Female ,medicine.symptom ,business ,Rifampicin ,medicine.drug - Abstract
WOS: 000336986700024, PubMed ID: 24557334, Brucellosis is a zoonotic disease that primarily affects the reticuloendothelial system. But, the extent of liver damage in due course of the disease is unclear. This study included 325 brucellosis patients with significant hepatobiliary involvement identified with microbiological analyses from 30 centers between 2000 and 2013. The patients with a parts per thousand yen5 times of the upper limit of normal for aminotransferases, total bilirubin level a parts per thousand yen2 mg/dl or local liver lesions were enrolled. Clinical hepatitis was detected in 284 patients (87.3 %) and cholestasis was detected in 215 (66.1 %) patients. Fatigue (91 %), fever (86 %), sweating (83 %), arthralgia (79 %), and lack of appetite (79 %) were the major symptoms. Laboratory tests showed anemia in 169 (52 %), thrombocytopenia in 117 (36 %), leukopenia in 81 (25 %), pancytopenia in 42 (13 %), and leukocytosis in 20 (6 %) patients. The most commonly used antibiotic combinations were doxycycline plus an aminoglycoside (n = 73), doxycycline plus rifampicin (n = 71), doxycycline plus rifampicin and an aminoglycoside (n = 27). The duration of ALT normalization differed significantly in three treatment groups (p < 0.001). The use of doxycycline and an aminoglycoside in clinical hepatitis showed better results compared to doxycycline and rifampicin or rifampicin, aminoglycoside, doxycycline regimens (p < 0.05). However, the length of hospital stay did not differ significantly between these three combinations (p > 0.05). During the follow-up, treatment failure occurred in four patients (1 %) and relapse was seen in three patients (0.9 %). Mortality was not observed. Hepatobiliary involvement in brucellosis has a benign course with suitable antibiotics and the use of doxycycline and an aminoglycoside regimen seems a better strategy in select patients.
- Published
- 2014