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Brucellosis-associated hepatitis

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Abstract

Aim

Brucellosis is a zoonotic infection that can affect almost every organ. A mild elevation of aminotransferase levels is usually observed in liver involvement. However, the development of clinical hepatitis is rare. In this study, we aimed to present the hospitalized cases with brucellosis hepatitis in our clinic in a 13-year period.

Methods

A hundred and three patients with significant hepatobiliary involvement, diagnosed by microbiological analysis, were included in the study. For the presence of hepatitis, it was required that the aminotransferases must be ≥ 5 times more than the upper limit and/or the total bilirubin level must be ≥ 2 mg/dl and/or the local hepatic lesion must be demonstrated.

Results

Of the cases, 35.9%, 17.5%, and 46.6% had clinical hepatitis, cholestatic hepatitis, and both clinical and cholestatic hepatitis, respectively. The most frequent symptom was fever (85.4%) while the most preferred treatment options were combinations containing aminoglycosides. It was observed that the mean time-interval to decrease to normal values of ALT, AST, and bilirubin values was 15.2 ± 7.8 days while the patients having their treatment regimens. In our study, which focused on liver involvement, it was found that a chronic liver disease did not develop in any of the cases.

Conclusion

Our study showed that, even in the presence of hepatitis, clinical response and laboratory improvement were high with appropriate treatment. It was observed that the improvement in aminotransferases and total bilirubin values delayed in the cases with blood culture positivity, secondary organ involvement, and alanine aminotransferase/aspartate aminotransferase > 1.

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Data availability

Data available on request from the authors.

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Acknowledgements

We would like to thank the whole medical microbiology laboratory team of our hospital that contributed to the collections and interpretation of serological and culture tests for the diagnosis of brucellosis, and all the doctors, nurses, and staff of our clinic who played a role in the diagnosis and treatment of patients. This study was derived from the thesis of medical specialty “Brucellosis-associated acute hepatitis: Our 13-year experience”.

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Authors and Affiliations

  1. Department of Infectious Diseases and Clinical Microbiology, Batman Training and Research Hospital, Batman, Turkey

    Yusuf Arslan

  2. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey

    Ali İrfan Baran

  3. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Harrran University, Şanlıurfa, Turkey

    Mehmet Çelik

Authors
  1. Yusuf Arslan
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  2. Ali İrfan Baran
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  3. Mehmet Çelik
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Contributions

YA and AIB designed the study and directed the study design. YA, AIB, and MC reviewed the literature and evaluated appropriate datasets. YA and MC performed statistical analysis. YA and AIB wrote the draft of the article. All authors contributed to discussion of results, interpretation and writing of the article and jointly approved the final article.

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Correspondence to Yusuf Arslan.

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Arslan, Y., Baran, A.İ. & Çelik, M. Brucellosis-associated hepatitis. Ir J Med Sci 193, 149–156 (2024). https://doi.org/10.1007/s11845-023-03382-x

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