Makis Alexandros, Perogiannaki Aikaterini, Chaliasos Nikolaos
Child Health Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece.
Case Rep Infect Dis. 2017;2017:3416857. doi: 10.1155/2017/3416857. Epub 2017 Jan 3.
Brucellosis is still endemic and a significant public health problem in many Mediterranean countries, including Greece. It is a multisystemic disease with a broad spectrum of clinical manifestations including hematological disorders, such as anemia, pancytopenia, leucopenia, and thrombocytopenia. Thrombocytopenia is usually moderate and attributed to bone marrow suppression or hypersplenism. Rarely, autoimmune stimulation can cause severe thrombocytopenia with clinically significant hemorrhagic manifestations. We present the case of a girl with severe thrombocytopenic purpura as one of the presenting symptoms of infection. Treatment with intravenous immunoglobulin and the appropriate antimicrobial agents promptly resolved the thrombocyte counts. A review of similar published cases is also presented.
布鲁氏菌病在包括希腊在内的许多地中海国家仍然流行,是一个重大的公共卫生问题。它是一种多系统疾病,临床表现广泛,包括血液系统疾病,如贫血、全血细胞减少、白细胞减少和血小板减少。血小板减少通常为中度,归因于骨髓抑制或脾功能亢进。很少情况下,自身免疫刺激可导致严重血小板减少并伴有具有临床意义的出血表现。我们报告了一例以严重血小板减少性紫癜为感染首发症状之一的女孩病例。静脉注射免疫球蛋白和适当的抗菌药物治疗迅速使血小板计数恢复正常。本文还对已发表的类似病例进行了综述。