Osteoarticular complications of childhood brucellosis: a study of 57 cases in Saudi Arabia.

Fifty-seven (36%) of a cohort of 157 children with brucellosis from Saudi Arabia had arthritis. Most gave a history of contact with farm animals or drinking unpasteurized milk. Associated features included pyrexia, arthralgia, hepatosplenomegaly, and lymphadenopathy. A subacute presentation with peripheral oligoarthritis predominantly affecting hips or knees was common. Specific chemotherapy resulted in rapid defervescence followed by slower resolution of the arthritis. Children with osteoarticular brucellosis had a higher relapse rate and a longer hospital stay. Supervised combination chemotherapy for at least 6 weeks was effective in preventing relapse. A brucellar etiology should be considered in any child from an endemic area who has osteoarticular manifestations.