Department of Pediatrics, Al-Khafji Joint Operation Hospital. Kingdom of Saudi Arabia.
Mediterr J Hematol Infect Dis. 2013;5(1):e2013011. doi: 10.4084/MJHID.2013.011. Epub 2013 Feb 16.
Hematological complications in brucellosis are common. Pancytopenia, although mainly reported in adults has also been described in children with brucellosis. This investigation was conducted to estimate the relative frequency of pancytopenia in children with brucellosis. The current study was conducted in Al-Khafji joint operation hospital, Saudi Arabia. Sixty patients with brucellosis, were enrolled in the study. Complete blood count (CBC) and blood culture were performed for all cases. Bone marrow (BM) aspiration was considered only in those with pancytopenia. Out of 60 children with brucellosis, 50 (83%) ingested raw animal milk and 27 (45%) had a positive family history of brucellosis. The common presenting symptoms and signs included excessive sweating (68%), bone aches (62%), chills (55%), arthritis (32%), hepatomegaly (18%), and splenomegaly (15%). The main hematological manifestations included anemia (43%), leukopenia (38%) and leukocytosis (20%). Pancytopenia was detected in 11 patients (18%). Blood culture for Brucella was positive in 38% (23 patients). B.melitensis from 21 patients was cultured in vitro. Out of 9 BM aspirate cultures, 3 were positive for B. melitensis. Out of 11 patients with pancytopenia, 9 (82%) patients had bone aches and weakness, 7 (64%) patients had sweating and chills, and 6 (55%) patients had petechiea and purpura.
The current study concludes that although pancytopenia is an uncommon complication of brucellosis in children, it does occur. Therefore, brucellosis should be considered in the differential diagnosis of pancytopenia in children, particularly in endemic areas such as Saudi Arabia.
评估儿童布鲁氏菌病患者中全血细胞减少症的相对频率。
本研究在沙特阿拉伯 Al-Khafji 联合行动医院进行。共纳入 60 例布鲁氏菌病患儿,所有患者均进行全血细胞计数(CBC)和血培养检查。仅对全血细胞减少症患者进行骨髓穿刺。
60 例布鲁氏菌病患儿中,50 例(83%)饮用生动物奶,27 例(45%)有布鲁氏菌病阳性家族史。常见的临床表现和体征包括过度出汗(68%)、骨痛(62%)、寒战(55%)、关节炎(32%)、肝肿大(18%)和脾肿大(15%)。主要的血液学表现包括贫血(43%)、白细胞减少(38%)和白细胞增多(20%)。11 例(18%)患者发现全血细胞减少症。38%(23 例)患者血培养布鲁氏菌阳性。21 例患者的 B.melitensis 在体外培养。9 例骨髓抽吸培养中,3 例为 B. melitensis 阳性。11 例全血细胞减少症患者中,9 例(82%)有骨痛和无力,7 例(64%)有出汗和寒战,6 例(55%)有瘀点和紫癜。
尽管儿童布鲁氏菌病全血细胞减少症并不常见,但确实存在。因此,在儿童全血细胞减少症的鉴别诊断中应考虑布鲁氏菌病,特别是在沙特阿拉伯等流行地区。