分析中山大学孙逸仙纪念医院急诊病区布鲁菌病的临床特征，为非牧区布鲁菌病的早期诊治和提高疗效提供临床依据。

回顾性分析中山大学孙逸仙纪念医院急诊病区2013年12月至2016年4月收治的12例布鲁菌病患者的流行病学资料，就临床表现、实验室检查、治疗和转归情况进行回顾性分析。

58%的患者有牛羊接触史。高热为主要临床表现(100%)，同时伴有畏寒、寒战、全身乏力、多汗，皮疹、头痛、耳后疼痛、咽痛、颈肩痛、腰背痛、肌肉关节痛、咳嗽、肝脾淋巴结肿大等。外周血象白细胞计数多数正常(83%)及少数轻度升高(17%)；多数中性粒细胞百分比正常(75%)，少数升高(17%)或下降(8%)；少数血小板计数减少(17%)；所有患者无贫血。多数患者(83%)伴有肝功能轻度异常，无黄疸。多数患者(92%)PCT轻度升高，所有患者(100%)C反应蛋白(CRP)呈不同程度升高。所有患者(100%)在广州市疾病预防控制中心(CDC)检测的布鲁菌试管凝集试验均为阳性，50%患者血培养或骨髓培养阳性。治疗方案包括多西环素＋利福平、多西环素＋链霉素、多西环素＋复方磺胺甲恶唑、多西环素＋莫西沙星或左氧氟沙星，所有患者经规范化联合抗菌药物治疗后总有效率为100%。

布鲁菌病的临床表现多样，非牧区患者易漏诊误诊，尤其对于长时间不明原因发热的患者，要详细询问接触史，警惕本病的可能，尽早进行血培养或布鲁杆菌凝集试验检查，规范化联合治疗方案具有良好的疗效。

To provide clinical evidence for early diagnosis and treatment of Brucellosis by analyzing the clinical characteristics of patient with brucellosis admitted in the Department of Emergency, Sun Yat-sun Memorial Hospital of Sun Yat-sen University.

Epidemiological, clinical, laboratory and treatment data, as well as outcomes of 12 patients diagnosed as brucellosis during December 2013 to April 2015 were retrospectively analyzed in this hospital.

The majority of patients were the middle-aged; seven (58.3%) patients had a history of close contact with sheep or cows infected with brucellosis. All patients had a high fever (100%), accompanied with chilly, fatigue, sweating, rash, headache, ear pain, sore throat, cervicobrachialgia, lumbodorsal pain, myalgia and arthralgia, cough, and lymphadenectasis. White blood cell count were normal in 10 cases (83%), and decreased in 2 cases (17%). The percentage of neutrophilic granulocytes was normal in 7 cases (75%), decreased in 2 cases (17%) and increased in 1 case (8%). Platelet count decreased in 2 cases (17%). All patients had no anemia. 10 patients (83 %) had hepatic dysfunction, but without jaundice. Almost 92% patients had mild elevation of PCT level, and the CRP level was variably elevated in all patients (100%). All 12 patients were positive in serum agglutination test for Brucella, and 6 (50%) positive in blood and bone marrow culture for Brucella. All patients had effective prognosis after standard treatment, including doxycycline combined rifampicin, doxycycline combined streptomycin, doxycycline combined TMP-SMZ, doxycycline combined moxifloxacin or levofloxacin.

Due to the diversity of clinical manifestation, doctors often make a misdiagnosis or a missed diagnosis of Brucellosis in non-pasture area. Detailed history of exposure to infectious agents, as well as blood culture or brucella aggregation test, should be performed as early as possible for patients with long-term fever of unknown origin. Standard combined treatment has good clinical efficacy.