Pappas G, Kitsanou M, Christou L, Tsianos E
Internal Medicine Department, University Hospital, Ioannina, Greece.
Am J Hematol. 2004 Mar;75(3):139-41. doi: 10.1002/ajh.10473.
Thrombocytopenia often complicates the course of acute brucellosis, mainly due to bone marrow suppression or hypersplenism. Immune thrombocytopenia is also reported in brucellosis, resulting usually in massive thrombocytopenia, purpura, and spontaneous hemorrhage. We describe a case of acute brucellosis in an 85-year old woman, who presented with fever, purpuric skin lesions, anemia, and rhinorrhagia. The absolute platelet count was 1000/microL. Direct and indirect Coombs tests were positive, and a cold-agglutinin was detected. The patient was diagnosed as suffering from brucellosis on the basis of a strongly positive serologic reaction and was treated with doxycycline, streptomycin, and a short course of corticosteroids, with a rapid rise in platelet number.
血小板减少症常使急性布鲁氏菌病病情复杂化，主要原因是骨髓抑制或脾功能亢进。布鲁氏菌病中也有免疫性血小板减少症的报道，通常会导致大量血小板减少、紫癜和自发性出血。我们描述了一名85岁女性的急性布鲁氏菌病病例，她出现发热、紫癜性皮肤病变、贫血和鼻出血。血小板绝对计数为1000/微升。直接和间接抗人球蛋白试验呈阳性，并检测到冷凝集素。根据血清学反应强阳性，该患者被诊断为患有布鲁氏菌病，并接受了强力霉素、链霉素和短期皮质类固醇治疗，血小板数量迅速上升。
