本文旨在分析云南红河州布鲁氏菌感染确诊患者的临床特征,并与文献报道病例进行比较,以期为该地区布鲁氏菌病的早期诊断和治疗提供理论依据。采用病例回顾性分析的方法,收集2018年1月—2022年12月收治的经血培养阳性确诊的36例布鲁氏菌感染患者的临床资料及相关检查结果;根据入院时患者的临床特征及诊治情况,进一步将其分为经典发热待查组和非经典发热待查组,分析2组患者的流行病学和临床特征。结果显示,确诊的36例患者中,其居住地以农村为主,占91.67%;疾病分期以急性期为主,占88.89%;发热是其最常见的临床症状之一,占94.44%,并发肝损伤患者比例高达80.56%。对2组患者的流行病学特征、临床特征、实验室检查结果及临床转归进行比较,可知非经典发热待查组较经典发热待查组患者的误诊率明显较高(94.74% vs. 64.71%,P=0.023);经典发热待查组发热伴寒战的比例明显高于非经典发热待查组(77.78% vs. 22.22%, P=0.000);其余资料差异均不显著(P>0.05)。本研究发现布鲁氏菌感染患者的误诊率高,非经典发热待查的患者更易被误诊为其他疾病。云南红河州地区布鲁氏菌感染事件全年均有散发,临床医师须高度重视流行病学接触史相关的问诊及实验室检查,尽量避免该病的漏诊及误诊。
To provide a theoretical basis for the early diagnosis and treatment of brucellosis in Honghe Prefecture, Yunnan Province, this study analyzed the clinical characteristics of confirmed cases of brucellosis in Yunnan region, and compared these cases with the reported cases in the literature. The clinical data of 36 patients with brucella infection confirmed by positive blood culture admitted from Jan. 2018 to Dec. 2022 were retrospectively analyzed. Based on the clinical characteristics and diagnosis, they were divided into classic fever of unknown origin (FOU) group and non classic fever of unknown origin (non-FOU) group, and the epidemiological and clinical characteristics of the two groups were analyzed. The results demonstrated that, 91.67% patients lived mainly in rural areas; the acute stage is mainly, accounting for 88.89%, fever is one of the most common clinical symptoms, accounting for 94.44%, and 80.56% were complicated with liver injury. Comparing the epidemiological characteristics, clinical features, laboratory test results, and clinical outcomes of the two groups of patients, the non-FUO group had a significantly higher misdiagnosis rate than the FUO group (94.74% vs. 64.71%, P=0.023); the proportion of fever accompanied by chills in the FUO group was significantly higher than that in the non-FUO group (77.78% vs. 22.22%, P=0.000). There was no statistical difference between the two groups in the remaining data (P>0.05). It was concluded that, brucellosis have a high misdiagnosis rate, and patients with non-FUO are more likely to be misdiagnosed as other diseases. Incidents of Brucella infection in the Honghe of Yunnan are sporadic throughout the year, and doctors need to attach great importance to inquiring about epidemiological history and relevant laboratory tests to reduce the missed diagnosis and misdiagnosis rate of the disease.