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Published on: August 5, 2016
Bone marrow hypoplasia during Brucella infection
Yildiz Yildirmak1, Ayşe Palanduz, Leyla Telhan
1Department of Pediatrics, Sişli Etfal Training and Research Hospital, Istanbul, Turkey.
Journal of Pediatric Hematology/Oncology
|January 25, 2003
Summary
Brucellosis can cause pancytopenia in children, a condition where bone marrow is underactive. This rare case highlights bone marrow hypoplasia as a potential cause of aplastic anemia in brucellosis-endemic regions.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Bone Marrow Pathology
Background:
- Pancytopenia, a decrease in all blood cell types, is recognized in pediatric brucellosis.
- Bone marrow hypoplasia, characterized by reduced cellularity, is an uncommon manifestation of brucellosis.
Observation:
- An 11-year-old boy presented with fever, vomiting, and abdominal pain, exhibiting pallor and high fever without lymphadenopathy or hepatosplenomegaly.
- Laboratory results revealed severe pancytopenia (Hemoglobin 8.6 g/dL, WBC 1,100/mm³, Neutrophils 500/mm³, Platelets 56,000/mm³), with low reticulocytes (0.1%).
- Bone marrow aspiration and biopsy confirmed hypocellularity, and a high brucellosis agglutination titer (>1/640) was detected.
Findings:
- The patient was treated with trimethoprim/sulfamethoxazole, leading to fever resolution and subsequent improvement in pancytopenia.
- Brucellosis-induced pancytopenia is typically linked to hypersplenism, hemophagocytosis, or granulomatous bone marrow infiltration, usually resulting in a hypercellular marrow.
- This case underscores the rare occurrence of bone marrow hypoplasia in pediatric brucellosis.
Implications:
- Bone marrow hypoplasia should be considered in the differential diagnosis of aplastic anemia in children, particularly in regions where brucellosis is prevalent.
- Early diagnosis and treatment of brucellosis are crucial for managing hematological complications like pancytopenia.
- This case expands the understanding of the diverse hematological presentations of pediatric brucellosis.
