Severe Thrombocytopenia With Wet Purpura in Brucellosis: A Case Report

Brucellosis is a zoonotic infection that passes to humans from infected animals via direct contact or the intake of raw milk and its products. The hematologic profile most frequently seen in acute brucellosis includes mild anemia and leukopenia. Severe form of thrombocytopenia and multiple wet purpura over the tongue and buccal mucosa are less frequently reported. This article describes a case of a 24-year-old man who presented with an absolute platelet count of 1000 × 10³/L; multiple wet purpura over the tongue and buccal mucosa and petechial lesions on the distal shins. The patient was diagnosed with brucellosis according to a positive serologic test and was treated with an antibiotic regimen including ceftriaxone and doxycycline, dexamethasone and a transfusion of 6 units of platelets. Mucocutaneous lesions resolved after 3 days of hospitalization, and platelet counts showed a steady upward trend. Brucella infection may cause severe thrombocytopenia and wet purpura over the tongue and buccal mucosa, which can be reversed with appropriate antimicrobials and steroids.