Hemophagocytic syndrome in a child with brucellosis

Area of Science:

• Pediatrics
• Infectious Diseases
• Hematology

Background:

• Brucellosis is a zoonotic infection that can present with nonspecific symptoms.
• Hepatosplenomegaly is a common finding in pediatric infections.
• Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome of excessive immune activation.

Observation:

• A 2.5-year-old female child presented with a month of fever and hepatosplenomegaly.
• Despite prolonged symptoms, the child initially appeared stable.
• Rapid clinical deterioration occurred post-admission.

Findings:

• Investigations confirmed hemophagocytosis, a hallmark of HLH.
• Brucella infection was identified as the underlying cause.
• The combination of brucellosis and hemophagocytosis is rare in children.

Implications:

• This case underscores the importance of considering brucellosis in febrile children with hepatosplenomegaly, especially in endemic areas.
• Early recognition and management of brucellosis-associated HLH are critical for improving patient outcomes.
• Further research into the pathogenesis and treatment of brucellosis-induced HLH is warranted.