Aypak Adalet, Aypak Cenk, Bayram Yasemin
Department of Infectious Diseases and Clinical Microbiology.
Department of Family Medicine, Van Gevaş State Hospital.
Pediatr Int. 2015 Dec;57(6):1108-11. doi: 10.1111/ped.12688. Epub 2015 Oct 20.
Brucellosis produces a variety of non-specific hematological abnormalities. The aim of the present study was to evaluate the hematological findings in childhood brucellosis.
Medical records of children with brucellosis admitted to a tertiary hospital in a 1 year period, were analyzed retrospectively.
Sixty-nine patients (mean age, 14.5 ± 3.3 years) were diagnosed with brucellosis. The most common hematological finding was thrombocytopenia (n = 11, 15.9%). Thrombocytosis was detected in five patients (7.3%), leukopenia in four (5.8%), anemia in three (4.3%), and bicytopenia in three (4.3%). None of the patients had pancytopenia. Blood culture was positive for Brucella spp. in 41 patients (59.4%). Among those patients with positive blood culture, six (14.6%) had serum agglutination test titer ≤1/80. Platelet (PLT) count was significantly lower in the bacteremia-positive group. The OR (95%CI) of bacteremia for PLT cut-off 200,000/mm(3) was 0.148 (95%CI: 0.031-0.718) and relative risk was 1.718 (95%CI: 1.244-2.372; P = 0.010).
Brucellosis should be kept in mind in the differential diagnosis of isolated thrombocytopenia in pediatric patients from endemic areas.
布鲁氏菌病会导致多种非特异性血液学异常。本研究旨在评估儿童布鲁氏菌病的血液学表现。
回顾性分析一家三级医院在1年期间收治的布鲁氏菌病患儿的病历。
69例患者（平均年龄14.5±3.3岁）被诊断为布鲁氏菌病。最常见的血液学表现是血小板减少（n = 11，15.9%）。5例患者（7.3%）检测到血小板增多，4例（5.8%）白细胞减少，3例（4.3%）贫血，3例（4.3%）全血细胞减少。所有患者均无全血细胞减少。41例患者（59.4%）血培养布鲁氏菌属阳性。在血培养阳性的患者中，6例（14.6%）血清凝集试验滴度≤1/80。菌血症阳性组的血小板（PLT）计数显著较低。血小板计数临界值为200,000/mm³时，菌血症的OR（95%CI）为0.148（95%CI：0.031 - 0.718），相对危险度为1.718（95%CI：1.244 - 2.372；P = 0.010）。
对于来自流行地区的儿科患者，在孤立性血小板减少的鉴别诊断中应考虑布鲁氏菌病。
