An uncommon case of acute brucellosis presenting with severe thrombocytopenia

Intern Med. 2012;51(23):3291-3. doi: 10.2169/internalmedicine.51.7365. Epub 2012 Dec 1.

Abstract

A 49-year-old man was admitted to the hospital with complaints of fatigue, epistaxis and a skin rash. The whole blood count revealed isolated thrombocytopenia (4,000/mL), and the patient was admitted to the hematology department with a diagnosis of immune thrombocytopenia. He did not respond to steroid treatment for 15 days, and a subfebrile fever developed during this period. A diagnosis of acute brucellosis was considered due to positive serological tests and a blood culture positive for Brucella spp. After starting doxycycline and rifampicin therapy, the patient's thrombocyte count increased to 15,000/mL on the third day, to 41,000/mL on the sixth day and was normal on the 21st day of treatment. A diagnosis of brucellosis must be considered in patients presenting with severe and isolated thrombocytopenia in countries where brucellosis is endemic.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Brucellosis / complications*
  • Brucellosis / diagnosis*
  • Brucellosis / drug therapy
  • Diagnosis, Differential
  • Doxycycline / administration & dosage
  • Drug Therapy, Combination
  • Humans
  • Male
  • Middle Aged
  • Platelet Count
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis
  • Rifampin / administration & dosage
  • Thrombocytopenia / blood
  • Thrombocytopenia / etiology*
  • Turkey
  • Zoonoses / complications
  • Zoonoses / diagnosis
  • Zoonoses / drug therapy

Substances

  • Anti-Bacterial Agents
  • Doxycycline
  • Rifampin