El-Koumi Mohamad A, Afify Mona, Al-Zahrani Salha H
Department of Pediatrics, Al-Khafji Joint Operation Hospital , Kingdom of Saudi Arabia.
Department of Biology, Science College for Girls King AbdulAziz University , Kingdom of Saudi Arabia.
Iran J Pediatr. 2014 Apr;24(2):155-60.
Hematological complications of 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 Operations 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 (18%) patients. 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 sweating and chills, 6 (55%) patients petechiae 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.
布鲁氏菌病的血液学并发症很常见。全血细胞减少症虽然主要在成人中报道，但在患布鲁氏菌病的儿童中也有描述。进行这项调查是为了估计患布鲁氏菌病儿童中全血细胞减少症的相对发生率。
本研究在沙特阿拉伯的海夫吉联合行动医院进行。60例布鲁氏菌病患者纳入研究。对所有病例进行全血细胞计数（CBC）和血培养。仅对全血细胞减少的患者进行骨髓穿刺。
60例患布鲁氏菌病的儿童中，50例（83%）摄入过生动物奶，27例（45%）有布鲁氏菌病家族史阳性。常见的症状和体征包括：多汗（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%）患者检测到全血细胞减少。布鲁氏菌血培养阳性率为38%（23例患者）。从21例患者中培养出了羊种布鲁氏菌。在9例骨髓穿刺培养中，3例羊种布鲁氏菌阳性。11例全血细胞减少的患者中，9例（82%）有骨痛和乏力，7例（64%）有出汗和寒战，6例（55%）有瘀点和紫癜。
本研究得出结论，虽然全血细胞减少症是儿童布鲁氏菌病的一种不常见并发症，但确实会发生。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。
