title: A prospective study of brucellosis in children: relative frequency of pancytopenia.
abstract: OBJECTIVE
  Hematological complications of brucellosis are common. Pancytopenia, although mainly reported in adults, has also been described in children with brucellosis. This investigation was conducted to estimate the relative frequency of pancytopenia in children with brucellosis.
  
  
  METHODS
  The current study was conducted in Al-Khafji Joint Operations Hospital, Saudi Arabia. Sixty patients with brucellosis were enrolled in the study. Complete blood count (CBC) and blood culture were performed for all cases. Bone marrow (BM) aspiration was considered only in those with pancytopenia.
  
  
  RESULTS
  Out of 60 children with brucellosis, 50 (83%) ingested raw animal milk and 27 (45%) had a positive family history of brucellosis. The common presenting symptoms and signs included: excessive sweating (68%), bone aches (62%), chills (55%), arthritis (32%), hepatomegaly (18%) and splenomegaly (15%). The main hematological manifestations included: anemia (43%), leukopenia (38%) and leukocytosis (20%). Pancytopenia was detected in 11 (18%) patients. Blood culture for Brucella was positive in 38% (23 patients). B. melitensis from 21 patients was cultured in vitro. Out of 9 BM aspirate cultures, 3 were positive for B. melitensis. Out of 11 patients with pancytopenia, 9 (82%) patients had bone aches and weakness, 7 (64%) patients sweating and chills, 6 (55%) patients petechiae and purpura.
  
  
  CONCLUSIONS
  The current study concludes that although pancytopenia is an uncommon complication of brucellosis in children, it does occur. Therefore, brucellosis should be considered in the differential diagnosis of pancytopenia in children, particularly in endemic areas such as Saudi Arabia.
authors.affiliation: Department of Pediatrics, Al-Khafji Joint Operation Hospital , Kingdom of Saudi Arabia.
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: El-Koumi
authors.affiliation: Department of Biology, Science College for Girls King AbdulAziz University , Kingdom of Saudi Arabia.
authors.forename: Mona
authors.initials: M
authors.lastname: Afify
authors.affiliation: Department of Biology, Science College for Girls King AbdulAziz University , Kingdom of Saudi Arabia.
authors.forename: Salha H
authors.initials: SH
authors.lastname: Al-Zahrani
keywords: Endemic Brucellosis; Fever of Unknown Origin; Pancytopenia