title: Bone marrow hypoplasia during Brucella infection.
abstract: Pancytopenia, although mainly reported in adults, has also been described in children with brucellosis. However, bone marrow hypoplasia is a rare feature of the infection. An 11-year-old boy was admitted with fever, vomiting, and abdominal pain of 10 days' duration. On physical examination, pallor and high fever were detected in the absence of lymphadenopathy and hepatosplenomegaly. His hemoglobin was 8.6 g/dL, white blood cell count 1,100/mm(3), neutrophil count 500/mm(3), platelets 56,000/mm(3), and reticulocytes 0.1%. Hypocellular bone marrow was found by aspiration, and bone marrow biopsy revealed hypocellularity. The agglutination titer was greater than 1/640. Trimethoprim/sulfamethoxazole was prescribed. His fever subsided and pancytopenia subsequently improved. Pancytopenia associated with brucellosis is attributed to hypersplenism, hemophagocytosis, and granulomatous lesions of the bone marrow, which is usually hypercellular. Bone marrow hypoplasia is rarely reported and should be kept in mind in the etiology of aplastic anemia in a country where brucellosis is frequently encountered.
authors.affiliation: Department of Pediatrics, Sişli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Yildiz
authors.initials: Y
authors.lastname: Yildirmak
authors.forename: Ayşe
authors.initials: A
authors.lastname: Palanduz
authors.forename: Leyla
authors.initials: L
authors.lastname: Telhan
authors.forename: Müjde
authors.initials: M
authors.lastname: Arapoglu
authors.forename: Nimet
authors.initials: N
authors.lastname: Kayaalp
mesh_terms: D000372:Agglutination Tests; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001772:Blood Cell Count; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology*; D001855:Bone Marrow Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002002:Brucella / Q000302:isolation & purification; D002006:Brucellosis / Q000150:complications* / Q000188:drug therapy; D002648:Child; D006801:Humans; D008297:Male; D010198:Pancytopenia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination