Summary
We prospectively studied 339 patients diagnosed of brucellosis over a six year period in order to evaluate the clinical and serological characteristics of brucellosis in the elderly. 319 patients (94.1%) were under 65 years of age (group A), and 20 patients (5.9%) were older than 65 (group B). No patient in group B developed splenomegaly as opposed to 69 (21.6%) in group A (p<0.05). The percentage of positive blood cultures (Brucella melitensis isolated in all cases) was 72.1% in group A and 60% in group B. The mean titer of IgM antibodies measured by indirect immunofluorescence test was significantly lower in the elderly patients, with no other differences in serologic response between the two groups. 103 patients (32.2%) in group A and seven patients (35%) in group B developed some complications; spondylitis was more common and severe among group B patients. There was no therapeutic failure or relapse among patients over 65. We conclude that clinical, bacteriological and serological characteristics and the outcome of brucellosis in the elderly are similar to those seen in younger patients.
Zusammenfassung
Zur Erfassung der klinischen und serologischen Eigenschaften der Bruzellose bei älteren Patienten wurden über einen Zeitraum von sechs Jahren 339 Patienten, bei denen eine Bruzellose diagnostiziert wurde, im Rahmen einer prospektiven Studie untersucht. 319 der Patienten (94,1%) waren jünger als 65 Jahre (Gruppe A), 20 (5,9%) waren über 65 Jahre (Gruppe B). Eine Splenomegalie trat bei Patienten der Gruppe B in keinem Fall auf, aber bei 69 (21,6%) der Patienten in Gruppe A (p<0,05). Bei 72,1% der Patienten in Gruppe A und 60% der Patienten in Gruppe B war die Blutkultur positiv. In allen Fällen wurdeBrucella melitensis isoliert. Bei den älteren Patienten waren die mittels Immunfluoreszenztest bestimmten IgM-Antikörpertiter im Mittel signifikant niedriger als bei den jüngeren, doch bestand prinzipiell kein Unterschied bezüglich der serologischen Antwort auf die Infektion. Komplikationen traten bei 103 Patienten der Gruppe A (32,2%) und sieben Patienten der Gruppe B (35%) auf, wobei in der letztgenannten Gruppe eine Spondylitis häufiger beobachtet wurde. Bei Patienten über 65 wurde in keinem Fall Therapieversagen oder ein Rezidiv festgestellt. Wir nehmen an, daß die klinischen, bakteriologischen und serologischen Charakteristika und der Verlauf der Bruzellose bei älteren Patienten ähnlich sind wie bei jüngeren Patienten.
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Colmenero, J.D., Reguera, J.M., Cabrera, F.P. et al. Serology, clinical manifestations and treatment of brucellosis in different age groups. Infection 18, 152–156 (1990). https://doi.org/10.1007/BF01642103
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DOI: https://doi.org/10.1007/BF01642103