Brucellosis is one of the most common zoonotic diseases in the world. The epidemiological situation of brucellosis in the Russian Federation is characterized as unfavorable. The problem of brucellosis remains of particular relevance in regions with developed animal husbandry. Many different clinical manifestations and the absence of specific symptoms of brucellosis make it difficult to diagnose this disease. The clinical case presented in this paper illustrates the delayed diagnosis of brucellosis in a 10-year-old patient with fever, enlarged lymph nodes, liver and spleen. The defects in the provision of medical care were based on the lack of alertness of doctors regarding brucellosis, insufficient interpretation of epidemiological history data and incorrect assessment of the totality of clinical syndromes of the disease and laboratory parameters. As a result, brucellosis was diagnosed only six months after the onset of the disease. Subsequent etiotropic therapy led to stabilization of the patient's condition, who was discharged from the hospital with recommendations under the supervision of an infectious disease specialist.

The widespread use of macrolide antibiotics in clinical practice emphasizes the need to address issues related to their safety and the possible development of adverse drug reactions (ADRs). One of the common methods of identifying ADRs through retrospective analysis of medical records is the global trigger tool (GTT) proposed in 2003. Objective. Study aimed to conduct a retrospective analysis of medical records of patients of the infectious hospital for the detection of triggers of ADRs. Material and methods. A retrospective study of medical records of 150 patients who were treated at the Infectious Clinical Hospital No.1 in 2020-2022, using the GTT was carried out. The selection of medical records to search for the triggers was performed by random sampling from the records with established diagnoses of lower respiratory tract infections (bronchitis, pneumonia) and upper respiratory tract infections (sinusitis, tonsillitis). Results. After an analysis of 150 case histories, 36 triggers and 22 cases of ADRs were identified by two independent investigators. It was found that the most frequently used antibiotic from the macrolide group was azithromycin, which was prescribed in 131 cases (87.3%). In the remaining 19 patients, erythromycin was prescribed (12.7%). Discussion. All of the identified ADRs were classified as having been temporarily detrimental to the patients’ health. Most of the detected ADRs occurred during the use of standard treatment regimens and were not preventable. Conclusion. It was found that the application of GTT in clinical practice will allow to identify implicit adverse events and simplify their search in general.