Abstract
OBJECTIVE: To enhance the clinical awareness of Brucella melitensis by retrospectively analyzing a case of septicemia caused by this bacterial infection in a pediatric patient. METHODS: The clinical data from a case of Brucella melitensis-induced septicemia in a child treated at Baoding Hospital, Beijing Children's Hospital, Capital Medical University, in June 2024 were retrospectively reviewed. The patient's condition and biochemical test results were analyzed and summarized. RESULTS: Three weeks before the onset of illness, the patient had a history of raw beef exposure. The primary clinical manifestation was undulant fever. Hematological tests revealed elevated C-reactive protein and erythrocyte sedimentation rate, accompanied by tenderness in the right hip joint and a positive "4 Sign" on the right side. The hip joint ultrasound was unremarkable. Blood culture identified Brucella melitensis after 72 hours of incubation, and serum agglutination test showed positive Brucella antibodies with a titer of 1:400. The patient was treated with ceftriaxone for antibacterial therapy, supplemented with doxycycline. Supportive therapy included bicyclol, glutathione, and L-ornithine L-aspartate for hepatoprotection. After 7 days of treatment, the patient's body temperature normalized, joint pain subsided, and liver function significantly improved, with AST decreasing from 215 U/L to 47 U/L and ALT from 213 U/L to 53 U/L. The treatment lasted six weeks. The patient's condition remained stable after discharge, with follow-up blood tests, liver function tests, and blood cultures showing no abnormalities. CONCLUSION: For patients with suspected infections, it is crucial to actively identify the causative pathogen and administer appropriate antimicrobial therapy based on laboratory results. Clinicians should emphasize etiological testing, using various staining techniques to improve diagnostic accuracy when identifying bacterial colonies on culture plates.