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免疫功能正常的布鲁氏菌病患者出现发热性中性粒细胞减少症:一例病例报告及文献综述

Febrile neutropenia in an immunocompetent patient with brucellosis: a case report and literature review.

作者信息

Khan Fasih Mand, Khan Ariba, Raja Sandesh, Raja Adarsh, Qammar Asfia, Chaulagain Aayush

机构信息

Fatima Memorial College of Medicine and Dentistry, Lahore, Pakistan.

Services Institute of Medical Sciences, Lahore, Pakistan.

出版信息

Ann Med Surg (Lond). 2025 Jan 9;87(1):383-386. doi: 10.1097/MS9.0000000000002823. eCollection 2025 Jan.

Abstract

INTRODUCTION AND IMPORTANCE

Brucellosis is a zoonotic disease that can affect various organs, with symptoms like fever, lymphadenopathy, and arthritis. Hematologic complications, including febrile neutropenia, are rare. This report highlights the diagnostic and therapeutic challenges of brucellosis with febrile neutropenia.

CASE PRESENTATION

A 36-year-old man presented with a 3-week history of fever, polyarthralgia, and night sweats. Examination showed febrile symptoms, joint swelling, and cervical lymphadenopathy. Laboratory tests revealed neutropenia and elevated inflammatory markers. Imaging was unremarkable, and blood cultures were negative, but brucellosis was confirmed by serology. Treatment with doxycycline and rifampicin led to clinical improvement.

CLINICAL DISCUSSION

Brucellosis diagnosis can be challenging due to nonspecific symptoms and requires high suspicion, especially in non-endemic areas. In this case, early identification and targeted therapy led to symptom resolution. This case underlines the importance of considering zoonotic diseases in febrile neutropenia with inconclusive initial findings.

CONCLUSION

Brucellosis with febrile neutropenia is rare but manageable with timely diagnosis and treatment, leading to favorable outcomes.

摘要

引言与重要性

布鲁氏菌病是一种人畜共患疾病,可累及多个器官,症状包括发热、淋巴结病和关节炎。血液学并发症,如发热性中性粒细胞减少症,较为罕见。本报告强调了伴有发热性中性粒细胞减少症的布鲁氏菌病的诊断和治疗挑战。

病例介绍

一名36岁男性,有3周的发热、多关节痛和盗汗病史。检查发现有发热症状、关节肿胀和颈部淋巴结病。实验室检查显示中性粒细胞减少和炎症标志物升高。影像学检查无异常,血培养阴性,但血清学检查确诊为布鲁氏菌病。使用多西环素和利福平治疗后临床症状改善。

临床讨论

由于症状不具特异性,布鲁氏菌病的诊断可能具有挑战性,需要高度怀疑,尤其是在非流行地区。在本病例中,早期识别和针对性治疗使症状得以缓解。该病例强调了在初始检查结果不明确的发热性中性粒细胞减少症中考虑人畜共患疾病的重要性。

结论

伴有发热性中性粒细胞减少症的布鲁氏菌病虽罕见,但及时诊断和治疗可控制病情,取得良好预后。

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