Severe thrombocytopenic purpura due to brucellosis

A case of severe thrombocytopenic purpura as the sole manifestation of brucellosis in an 11-y-old boy is presented. Clinical examination was negative and laboratory tests revealed anemia, leukopenia and severe thrombocytopenia. The initial diagnosis was idiopathic thrombocytopenic purpura and intravenous gamma globulin was given. A prompt hematological response was observed. However, on the fifth day after admission, blood culture yielded Brucella which could not be serotyped. The boy was subsequently treated with intravenous gentamicin, oral doxycycline and rifampicin and was discharged in good health. Brucellosis has occasionally been associated with mild hematological abnormalities such as anemia and leukopenia. Thrombocytopenia is rare and only in very rare cases it is severe enough to cause bleeding. Prompt recognition of this complication of brucellosis and aggressive therapy are essential, especially if there is a family history of brucellosis or if there is suspicion of exposure to infected food products.