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Online Hizmetlere Toplu BakışSouthern Clinics Of Istanbul Eurasia
South Clin Ist Euras. 2010; 21(1): 45-48 | |||
Atipik prezentasyonlu brusellozis olgusu: Akut hepatitVefik Arıca1, Seçil Günher Arıca2, İbrahim Şilfeler3, Hatice Onur4, Mehmet Tanır51Mustafa Kemal Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Hatay2Mustafa Kemal Üniversitesi Tıp Fakültesi, Aile Hekimliği Anabilim Dalı, Hatay 3Hassa Devlet Hastanesi, Çocuk Sağlığı ve Hastalıkları Kliniği, Hatay 4Iğdır Devlet Hastanesi, Çocuk Sağlığı ve Hastalıkları Kliniği, Iğdır 5Güven Hastanesi, Enfeksiyon Hastalıkları Kliniği, Van Bruselloz gelişmekte olan ülkelerde halen sık rastlanan bir hastalıktır. Brusella enfeksiyonu Türkiye’nin Doğu ve Güneydoğu bölgelerinde endemik olarak görülmektedir. Ülkemizde yılda yaklaşık 18.000 yeni olgu tespit edilmektedir. Bruselloz yaygın tutulumu olan bir hastalıktır. Birçok organ veya sistem tutulabilir. Gastrointestinal sistemde nadiren hepatit enfeksiyonlarına neden olabilir. Biz de bu yazıda çocuk kliniğimizde takip ettiğimiz Unusual presentation of brucella case: Acute hepatitisVefik Arıca1, Seçil Günher Arıca2, İbrahim Şilfeler3, Hatice Onur4, Mehmet Tanır51Mustafa Kemal University Faculty of Medicine, Department of Pediatrics, Hatay, Turkey2Mustafa Kemal University Faculty of Medicine, Department of Family Medicine, Hatay, Turkey 3Hassa State Hospital, Department of Pediatrics, Hatay, Turkey 4Igdir State Hospital, Department of Pediatrics, Igdir, Turkey 5Guven Hospital, Department of Clinical Infectious Diseases, Van, Turkey Brucellosis is a still frequently encountered disease in developing countries. Brucella infection is seen endemically in East and Southeast Turkey. Each year approximately 18.000 new cases are reported in our country. Brucellosis infects multiple systems within the body. Many organs and systems may be involved in brucella infection. Gastrointestinal involvement in brucellosis may rarely result in hepatitis. We present herein an acute hepatitis case due to brucella. A 14-year-old male patient presented with diffuse myalgia, weight loss, fever, vomiting, and fatigue. Physical examination revealed that skin, sclera and mucosal surfaces were all icteric, and the liver was palpable 4-5 cm below the costal margin. Laboratory investigations revealed aspartate aminotransferase (AST) 1310 U/L, alanine aminotransferase (ALT) 682 U/L, gamma glutamyl transpeptidase (GGT) 744 U/L, alkaline phosphatase (ALP) 402 U/L, total bilirubin 4.2 mg/dl, and conjugated bilirubin 1.9 mg/dl. Viral markers for hepatitis A, B and C were all negative. Brucella tube agglutination test was positive (1/320) and hemoculture revealed Brucella spp. Streptomycin and doxycycline treatment was initiated. Clinical response was noted within the 3rd day of treatment, and ALT, AST and total bilirubin levels returned to their normal levels on the 21st day of the treatment. Treatment lasted for 8 weeks. We present this case to underline that brucellosis should be kept in mind in the differential diagnosis of acute hepatitis, especially in regions where brucellosis is endemic. Keywords: Acute hepatitis, brucellosis, endemicVefik Arıca, Seçil Günher Arıca, İbrahim Şilfeler, Hatice Onur, Mehmet Tanır. Unusual presentation of brucella case: Acute hepatitis. South Clin Ist Euras. 2010; 21(1): 45-48 Sorumlu Yazar: Vefik Arıca, Türkiye |
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