Brucella bacteremia in patients with acute leukemia: a case series.
BACKGROUND
Brucellosis may cause serious infections in healthy individuals living in countries that are endemic for the infection. However, reports of brucella infections in immunocompromised hosts are relatively rare.


METHODS
Reported here are two patients with acute leukemia who developed Brucella melitensis bacteremia during their follow up at the Armed Forces Hospital in Riyadh. The first patient developed B. melitensis bacteremia during the transformation of his myelodysplasia into acute myeloid leukemia. The second patient developed B. melitensis bacteremia while his acute lymphoblastic leukemia was under control. Interestingly, he presented with acute cholecystitis during the brucella sepsis. Both brucella infections were associated with a marked reduction in the hematological parameters in addition to other complications. The bacteremic episodes were successfully treated with netilmicin, doxycycline and ciprofloxacin.


CONCLUSIONS
Brucellosis can cause systemic infections, complicated bacteremia and serious morbidity in patients with acute leukemia living in endemic areas. These infections may occur at the presentation of the leukemia or even when the leukemia is in remission. Nevertheless, the early diagnosis of brucellosis and the administration of appropriate antimicrobial therapy for sufficient duration usually improves the outcome in these immunocompromised patients.
Section of Adult Hematology and Hematopoietic, Stem Cell Transplant, King Faisal Cancer Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3345, Riyadh 11211, Saudi Arabia. kaa_alanazi@yahoo.com.
Khalid Ahmed
KA
Al-Anazi
Asma Marzouq
AM
Al-Jasser