Immune thrombocytopenic purpura associated with brucellosis. Case report and review of the literature.

A case of severe thrombocytopenic purpura as the sole manifestation of brucellosis in an eight-year-old boy is presented. Clinical examination revealed mucosal hemorrhages and splenomegaly. The initial diagnosis was immune thrombocytopenic purpura (ITP) and he received intravenous gamma globulins and steroids with good hematologic and clinical response. His brucella agglutination titer was positive and he received treatment with intravenous gentamicin and oral co-trimoxazole with good response. Although mild hematologic manifestations can be encountered in brucellosis, severe thrombocytopenia is rare. Prompt recognition of this association is essential for early therapy. A brief review of thrombo-cytopenic purpura associated with brucellosis is presented.